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General NPI Number Information
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NPI Number | 1609233006
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Entity Type | Individual
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Provider Name | LYNN M JOHNSON LCPC
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Gender | Female
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 01/15/2016
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Provider Practice Location Address
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Address Line | 10 E 22ND ST SUITE 217
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City | LOMBARD
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State | IL
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Zip | 60148-4977
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Country | US
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Telephone | 630-853-8356
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Fax |
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Provider Business Mailing Address
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Address Line | 211 S FAIR AVE
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City | ELMHURST
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State | IL
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Zip | 60126-3618
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Country | US
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Telephone | 630-853-8356
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.009868
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License Number State | IL
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