Individual
MR. ANTHONY M. L. JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
201 E GREEN ST, ITHACA, NY 14850-5635
(607) 274-6200
(607) 274-6224
Mailing address
201 E GREEN ST, ITHACA, NY 14850-5635
(607) 274-6200
(607) 274-6224
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
095740-1
NY
1041C0700X
Clinical Social Worker
Primary
087831
NY
Other
Enumeration date
04/01/2016
Last updated
01/15/2019
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