| Doctor Name: | JASON JOHNSTON |
| NPI Number: | 1023150034 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 2225 Deer Valley Rd Linden, TN - 37096 |
| Business Phone Number: | 9315892500 |
| Business Fax Number: | |
| Mailing Address: | 274 Williams Hollow Rd, LINDEN |
| State: | TN |
| Postal Code: | 370964622 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/13/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |