Individual
DR. JENNIFER MARIE JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, PHD
Contact information
Practice address
1679 MASSACHUSETTS AVE, SUITE 1, CAMBRIDGE, MA 02138-1807
(617) 803-6885
Mailing address
3 CONCORD AVE APT 43, CAMBRIDGE, MA 02138-3616
(617) 803-6885
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
9917
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5306
ALLIED MENTAL HEALTH LICE
MA
01
—
LM1021
BC/BS PROVIDER ID
MA
Enumeration date
07/31/2007
Last updated
12/11/2019
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