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NPI Code Detail

MEDICARE: MR. EDWARD ANGUS JOHNSTON M.S., LPC, LCAS

MEDICARE:  MR. EDWARD ANGUS JOHNSTON  M.S., LPC, LCAS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor1486NC
2101YP2500XProfessional Counselor7472NC
3101YM0800XMental Health Counselor7472NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457580847
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDWARD ANGUS JOHNSTON M.S., LPC, LCAS
Provider Business Mailing Address
First Line : 316 MARY LEE CT
Second Line :
City : WINTERVILLE
State : NC
Zip : 28590-9917
Country : US
Telephone Number : 252-341-4902
Fax Number : 252-355-7947
Provider Business Practice Location Address
First Line : 704 CROMWELL DR
Second Line : SUITE B
City : GREENVILLE
State : NC
Zip : 27858-5894
Country : US
Telephone Number : 252-341-4902
Fax Number : 252-355-7947
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2009
Last Update Date : 07/28/2013

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