Provider Demographics
NPI:1457715971
Name:JOHNSTON, AMANDA C M (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:C M
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 KEATING DR
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-1629
Mailing Address - Country:US
Mailing Address - Phone:504-393-5750
Mailing Address - Fax:504-393-5760
Practice Address - Street 1:115 KEATING DR
Practice Address - Street 2:
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-1629
Practice Address - Country:US
Practice Address - Phone:504-393-5750
Practice Address - Fax:504-393-5760
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8092101YP2500X
LAMFT1394106H00000X
LAPLM1394106H00000X
LAPLC8092101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist