MEDICARE: MR. STEVEN LAIRD JOHNSTON MA

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	101YP2500X	Professional Counselor	E.0002472	OH
2	101YP2500X	Professional Counselor	E-0002472	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	31-1074038	OTHER	OH	TAX ID

General Provider Information

NPI Number	:	1477669463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN LAIRD JOHNSTON MA

Provider Business Mailing Address
First Line	:	1308 EAGLE VIEW DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-6442
Country	:	US
Telephone Number	:	614-306-8895
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000 SUNBURY RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-1136
Country	:	US
Telephone Number	:	614-337-1986
Fax Number	:	614-337-2936

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

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	08/16/2023

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