| Lauren A Johnson Lcsw Pllc | |
|
1945 W Wilson Ave Ste 5115 Chicago IL 60640-5258 | |
| (312) 379-9350 | |
| Not Available |
| Full Name | Lauren A Johnson Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1945 W Wilson Ave Ste 5115, Chicago, Illinois |
| Authorized Official Name and Position | Lauren A Johnson (OWNER/MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 3123799350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lauren A Johnson Lcsw Pllc 1245 S Michigan Ave Ste 142 Chicago IL 60605-2408 Ph: () - | Lauren A Johnson Lcsw Pllc 1945 W Wilson Ave Ste 5115 Chicago IL 60640-5258 Ph: (312) 379-9350 |
| NPI Number | 1619582707 |
|---|---|
| Provider Enumeration Date | 09/15/2020 |
| Last Update Date | 11/18/2020 |
| Certification Date | 11/18/2020 |
| Medicare PECOS PAC ID | 6305257528 |
|---|---|
| Medicare Enrollment ID | O20201119001029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619582707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lauren Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518365857 PECOS PAC ID: 9830500057 Enrollment ID: I20201119001118 |
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