Individual
EDWARD RICHARDS JOHNSTON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPA
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1866
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0454A
BCBS OF NC
NC
05
—
6107299
—
NC
01
—
N/A
CBHA
NC
Enumeration date
03/09/2006
Last updated
04/19/2024
Update your record
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