Provider Demographics
NPI:1922720408
Name:JOHNSTON, SAMANTHA CAI (SLP)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:CAI
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:CAI
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:7413 SQUIRE CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2313
Mailing Address - Country:US
Mailing Address - Phone:513-847-4685
Mailing Address - Fax:513-847-4763
Practice Address - Street 1:7413 SQUIRE CT
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2313
Practice Address - Country:US
Practice Address - Phone:513-847-4685
Practice Address - Fax:513-847-4763
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.15617235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0027638Medicaid