Individual provider Active NPI

Elizabeth Montgomery Johnston

  • Mental Health Counselor
  • Smyrna, GA
National Provider Identifier
1043809361
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3050 Atlanta Rd SE
Smyrna, GA 30080-8255
Phone
(404) 944-0847
NPI assigned
Jan 12, 2021
Last updated
Jan 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

3050 Atlanta Rd SE
Smyrna, GA 30080-8255

Mailing address

4234 Harrogate Dr NW
Atlanta, GA 30327-3624
Phone (404) 944-0847

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ljohnston@greatoakcounseling.org Great Oak Counseling

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 14, 2024 through Feb 14, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1043809361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 HARROGATE DR NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303273624",
            "telephone_number": "404-944-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 ATLANTA RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808255",
            "telephone_number": "404-944-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "ELIZABETH",
        "middle_name": "MONTGOMERY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ljohnston@greatoakcounseling.org",
            "affiliation": "Y",
            "endpointDescription": "work email",
            "affiliationName": "Great Oak Counseling",
            "address_1": "3050 Atlanta Rd SE",
            "city": "Smyrna",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300808255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.