MEDICARE: PATRICIA JOHNSTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH22275	FL
2	101YM0800X	Mental Health Counselor	IMH14943	FL

General Provider Information

NPI Number	:	1114434602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA JOHNSTON

Provider Business Mailing Address
First Line	:	1429 ALETHA DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-4901
Country	:	US
Telephone Number	:	904-290-4067
Fax Number	:

Provider Business Practice Location Address
First Line	:	1429 ALETHA DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-4901
Country	:	US
Telephone Number	:	904-290-4067
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2018
Last Update Date	:	01/06/2026

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Directions to “ PATRICIA JOHNSTON ” Practice Location

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