MEDICARE: ANAMARIE HELEN JOHNSON

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	178.022949	IL

General Provider Information

NPI Number	:	1548151160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANAMARIE HELEN JOHNSON

Provider Business Mailing Address
First Line	:	3518 N BROADWAY ST APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-8630
Country	:	US
Telephone Number	:	317-617-4998
Fax Number	:

Provider Business Practice Location Address
First Line	:	3139 N LINCOLN AVE STE 228
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3173
Country	:	US
Telephone Number	:	773-741-4958
Fax Number	:

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

Provider Enumeration Date	:	07/11/2025
Last Update Date	:	03/17/2026

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