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General NPI Number Information
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NPI Number | 1619582707
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Entity Type | Organization
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Legal Business Name | LAUREN A JOHNSON LCSW PLLC
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 1945 W WILSON AVE STE 5115
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City | CHICAGO
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State | IL
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Zip | 60640-5258
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Country | US
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Telephone | 312-379-9350
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Fax |
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Provider Business Mailing Address
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Address Line | 1245 S MICHIGAN AVE STE 142
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City | CHICAGO
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State | IL
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Zip | 60605-2408
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MENTAL HEALTH THERAPIST
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Name | LAUREN A JOHNSON
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Credential |
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Telephone | 312-379-9350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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