Active NPI
Christian K Johstoneaux, LCSW
- Clinical Social Worker
- Heron, MT
National Provider Identifier
1215352240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SWP-LCSW-LIC7807
- Practice address
- 91 Clark Fork Rd
Heron, MT 59844-9595 - Phone
- (406) 847-5095
- Fax
- (406) 847-5014
- NPI assigned
- Feb 27, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6052317-3601 | UT | |
| Clinical Social Worker | 1041C0700X | SWP-LCSW-LIC7807 | MT | Primary |
Addresses
Primary practice location
91 Clark Fork Rd
Heron, MT 59844-9595
Mailing address
91 Clark Fork Rd # B
Heron, MT 59844-9595
Phone (406) 847-5095
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SWP-LCSW-LIC7807 | MT | MD | Clinical Social Worker |
| 6052317-3601 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395619200000",
"number": "1215352240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 CLARK FORK RD # B",
"city": "HERON",
"state": "MT",
"postal_code": "598449595",
"telephone_number": "406-847-5095",
"fax_number": "406-847-5014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 CLARK FORK RD",
"city": "HERON",
"state": "MT",
"postal_code": "598449595",
"telephone_number": "406-847-5095",
"fax_number": "406-847-5014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHSTONEAUX",
"first_name": "CHRISTIAN",
"middle_name": "K",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-27",
"last_updated": "2014-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "6052317-3601",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "SWP-LCSW-LIC7807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Heron, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.