Ilinka Alexandrovna-Johnston, MA

Individual provider Active NPI Psychologist · Varnville, SC

NPI 1467623652 · NPPES record last updated Mar 17, 2008

Key facts

NPI
1467623652
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
Practice address
65 Forest Drive
Varnville, SC 29944
Phone
(843) 524-8899
NPI assigned
Mar 17, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past
since Apr 19, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Yes

Addresses

Primary practice location

65 Forest Drive
Varnville, SC 29944

Mailing address

1050 Ribaut Rd
Beaufort, SC 29902-5400
Phone (843) 524-8899

Other providers in Varnville, SC

All providers in Varnville, SC · Psychologist in South Carolina

Sources for this page

Verify at the official NPI Registry.