Jack Johnson, RSA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

219 W Chicago Ave
Chicago, IL 60654-5600

Phone

(872) 777-8110

NPI assigned

May 8, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1033967765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18555 WESTERN AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604303116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606545600",
            "telephone_number": "872-777-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JACK",
        "credential": "RSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gladys M Johnson, M.A. LCSW
• Grace Johnson
• Hannah Grace Johnson
• Hillary Johnson, M.D.
• Jabari Johnson, BCAT
• Jaclyn Kristene Johnson, CCC-SLP
• Jada Johnson
• Jada Johnson
• Jada Jaria Johnson, M.D
• Jakeem Maurice Johnson, DPT

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.