Mrs Domini Marie Johnson, MS, LCPC, NCC,CDVP in South Holland, IL

Mrs Domini Marie Johnson, MS, LCPC, NCC,CDVP is a medicare enrolled "Counselor - Professional" provider in South Holland, Illinois. Her current practice location is 16417 Evans Ave, South Holland, Illinois. You can reach out to her office (for appointments etc.) via phone at (708) 362-3916.

Mrs Domini Marie Johnson is licensed to practice in Illinois (license number 180004580) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1659609121.

Contact Information

	Mrs Domini Marie Johnson, MS, LCPC, NCC,CDVP
	16417 Evans Ave, South Holland, IL 60473-2350
	(708) 362-3916
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Domini Marie Johnson
Gender	Female
Speciality	Counselor - Professional
Location	16417 Evans Ave, South Holland, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1659609121
Provider Enumeration Date: 11/22/2009
Last Update Date: 04/11/2012

Medicare PECOS Information:

PECOS PAC ID: 0244619971
Enrollment ID: I20240109002355

Medical Identifiers

Medical identifiers for Mrs Domini Marie Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1659609121	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	180004580 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Domini Marie Johnson allows following entities to bill medicare on her behalf.

Entity Name	Erie Family Health Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1760499545 PECOS PAC ID: 9537050422 Enrollment ID: O20040322000689

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Domini Marie Johnson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Domini Marie Johnson, MS, LCPC, NCC,CDVP 16417 Evans Avenue, South Holland, IL 60473 Ph: (708) 362-3916	Mrs Domini Marie Johnson, MS, LCPC, NCC,CDVP 16417 Evans Ave, South Holland, IL 60473-2350 Ph: (708) 362-3916

Reviews and Comments

Counselor in South Holland, IL

Robert E Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 16278 Prince Dr, South Holland, IL 60473 Phone: 708-754-8815
Mr. Howard Julian Henry, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 900 E 162nd St, Suite 207, South Holland, IL 60473 Phone: 708-225-1237 Fax: 708-225-1338
Mrs. Ashley Elizabeth Anderson, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 401 E 162nd St Ste 209, Heritage Center: Refuge Christian Counseling, South Holland, IL 60473 Phone: 708-339-2769 Fax: 708-339-6776
Ms. Sherrice A Hoffman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 401 E 162nd St, South Holland, IL 60473 Phone: 773-819-5504
Janiese Myesha Asque, Counselor Medicare: Not Enrolled in Medicare Practice Location: 16519 Ellis Ave, South Holland, IL 60473 Phone: 312-599-3436
Antoinette Allen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 17051 Louis Ave, South Holland, IL 60473 Phone: 708-609-0124
Anthony Olujimi, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 15475 S Park Ave Ste 109, South Holland, IL 60473 Phone: 708-596-5680 Fax: 708-596-5687

Mrs Domini Marie Johnson, MS, LCPC, NCC,CDVP - Medicare Counselor in South Holland, IL