National Provider Identifier

Diane Lynn Johnston, LCSW-R

Diane Lynn Johnston, LCSW-R is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Canandaigua, NY and a listed phone number of (585) 396-4363.

NPI 1134232630Canandaigua, NYClinical Social Worker

Profile Overview

NPI
1134232630
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
August 17, 2006
Last Updated
July 09, 2007

Practice Location

  • 3019 County Complex Dr
  • Canandaigua, NY 14424-9505

Phone: (585) 396-4363

Mailing Address

  • 5080 Parrish Street Ext
  • Canandaigua, NY 14424-9178

Specialties

  • Clinical Social Worker (1041C0700X)
Full Record
NPI
1134232630
Entity Type
Individual
Last Name
Johnston
First Name
Diane
Middle Name
Lynn
Credential
LCSW-R
Provider Other Last Name
Egan
Provider Other First Name
Diane
Provider Other Middle Name
Johnston
Provider Other Credential Text
LCSW-R
Provider Other Last Name Type Code
1
Mailing Street Address
5080 Parrish Street Ext
Mailing City
Canandaigua
Mailing State
NY
Mailing ZIP Code
14424-9178
Mailing Country
US
Mailing Phone
(585) 394-5824
Practice Street Address
3019 County Complex Dr
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424-9505
Practice Country
US
Practice Phone
(585) 396-4363
Practice Fax
(585) 396-4993
Enumeration Date
August 17, 2006
Last Updated
July 09, 2007
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X)
Other Identifiers
07300033209 (NY), 3109089 (NY, Value Options), EM (NY, Excellus), 103283EU (NY, Preferred Care)