MEDICARE: MS. JULIE A JOHNSON MA LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	180004543	IL

General Provider Information

NPI Number	:	1487662110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIE A JOHNSON MA LCPC

Provider Business Mailing Address
First Line	:	13313 LARAMIE AVE
Second Line	:
City	:	CRESTWOOD
State	:	IL
Zip	:	60418-1488
Country	:	US
Telephone Number	:	773-383-7033
Fax Number	:

Provider Business Practice Location Address
First Line	:	2656 W. MONTROSE
Second Line	:	SUITE 113
City	:	CHICAGO
State	:	IL
Zip	:	60618
Country	:	US
Telephone Number	:	773-383-7033
Fax Number	:	773-920-3316

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	04/24/2026

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