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General NPI Number Information
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NPI Number | 1548176233
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Entity Type | Individual
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Provider Name | FLYNN MARY JOHNSON M.S., LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 3100 DUNDEE RD STE 703
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City | NORTHBROOK
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State | IL
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Zip | 60062-2442
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Country | US
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Telephone | 872-273-6354
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 LAKE COOK RD APT 440
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City | DEERFIELD
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State | IL
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Zip | 60015-5302
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Country | US
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Telephone | 847-849-0024
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 166.012160
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License Number State | IL
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