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General NPI Number Information
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NPI Number | 1881506384
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Entity Type | Individual
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Provider Name | BENJAMIN GEORGE JOHNSTUN LPC
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Gender | Male
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Dates
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Enumeration Date | 09/19/2026
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Last Update Date | 09/19/2026
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Provider Practice Location Address
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Address Line | 3910 S YELLOWSTONE HWY STE 111
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City | IDAHO FALLS
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State | ID
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Zip | 83402-4342
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Country | US
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Telephone | 208-358-8313
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Fax |
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Provider Business Mailing Address
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Address Line | 1827 WHITNEY ST
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City | IDAHO FALLS
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State | ID
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Zip | 83402-1701
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Country | US
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Telephone | 503-396-9993
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6281537
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6281537
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6281537
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License Number State | ID
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