Individual provider Active NPI

Jennifer J. Johnston, L.C.S.W.

  • Clinical Social Worker
  • Crystal Lake, IL
National Provider Identifier
1003931619
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-012075 Issued in IL
Practice address
741 S McHenry Ave Ste C
Crystal Lake, IL 60014-7445
Phone
(847) 401-8205
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149012075 IL
Clinical Social Worker 1041C0700X 149-012075 IL Primary

Addresses

Primary practice location

741 S McHenry Ave Ste C
Crystal Lake, IL 60014-7445

Mailing address

741 S McHenry Ave Ste C
Crystal Lake, IL 60014-7445
Phone (847) 401-8205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110419000393 IL Practitioner - Clinical Social Worker 5799960696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

741 S McHenry Ave
Suite C
Crystal Lake, IL 60014-7445
Phone (847) 401-8205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-012075ILMDClinical Social Worker
149012075ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Johnston LCSW PC CurrentSince Jun 9, 2016 Accepting new patients
Melissa a Mankoff LCSW LLC Clinical Past Accepting new patients
Cherry Hill Associates, LLC Clinical PastSince Mar 22, 2023 Accepting new patients

Locations

600 Dakota St
Ste B
Crystal Lake, IL 60012
Phone (815) 276-3947

741 S McHenry Ave
Ste C
Crystal Lake, IL 60014
Phone (224) 650-6788

977 Lakeview Pkwy
Ste 180
Vernon Hills, IL 60061
Phone (847) 361-2334

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1003931619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 S MCHENRY AVE STE C",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147445",
            "telephone_number": "847-401-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 S MCHENRY AVE STE C",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147445",
            "telephone_number": "847-401-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "JENNIFER",
        "middle_name": "J.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012075",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-012075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.