| Doctor Name: | MR. MICHAEL CLARENCE JOHNSTON |
| NPI Number: | 1780999847 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MHS, LPC, CA-C |
| License Number: | PC005541 |
| Business Practice Address: | 1843 Route 209 South Safeway Storage Complex Brodheadsville, PA - 18322 |
| Business Phone Number: | 5704260096 |
| Business Fax Number: | 5709921723 |
| Mailing Address: | 1843 Route 209, South Safeway Storage Suite 1 SCIOTA |
| State: | PA |
| Postal Code: | 18322 |
| Phone Number: | 5704260096 |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2010 |
| NPI Last Update Date: | 12/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC005541 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |