| Jennifer Johnston Lcsw | |
|
977 Lakeview Pkwy Suite 180 Vernon Hills IL 60061-1400 | |
| (847) 401-8205 | |
| (847) 549-8006 |
| Full Name | Jennifer Johnston Lcsw |
|---|---|
| Speciality | Counselor |
| Location | 977 Lakeview Pkwy, Vernon Hills, Illinois |
| Authorized Official Name and Position | Jennifer J Johnston (OWNER) |
| Authorized Official Contact | 8474018205 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Johnston Lcsw 977 Lakeview Pkwy Suite 180 Vernon Hills IL 60061-1400 Ph: (847) 401-8205 | Jennifer Johnston Lcsw 977 Lakeview Pkwy Suite 180 Vernon Hills IL 60061-1400 Ph: (847) 401-8205 |
| NPI Number | 1215383781 |
|---|---|
| Provider Enumeration Date | 05/13/2016 |
| Last Update Date | 05/13/2016 |
| Medicare PECOS PAC ID | 4587959507 |
|---|---|
| Medicare Enrollment ID | O20160829003322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215383781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 149-012075 (Illinois) | Primary |
| Provider Name | Jennifer J Johnston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003931619 PECOS PAC ID: 5799960696 Enrollment ID: I20110419000393 |
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