Healthcare Provider Details

I. General information

NPI: 1003293473
Provider Name (Legal Business Name): BRITTANY JOHNSON MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 W JOHN ST
YORKVILLE IL
60560-9249
US

IV. Provider business mailing address

22 HERITAGE DR STE 100
BOURBONNAIS IL
60914-2501
US

V. Phone/Fax

Practice location:
  • Phone: 630-553-9100
  • Fax: 630-553-0167
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.017061
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6772
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: