Provider Demographics
NPI:1386916757
Name:JOHNSTON, ERIN MOYER (MS, LMHC)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MOYER
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 FATIO RD
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-4938
Mailing Address - Country:US
Mailing Address - Phone:386-795-6864
Mailing Address - Fax:
Practice Address - Street 1:409 FATIO RD
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-4938
Practice Address - Country:US
Practice Address - Phone:386-795-6864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6486101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health