Christine Johnson, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180-002794 Issued in IL

Practice address

702 Bloomington Rd Ste 214
Champaign, IL 61820-2560

Phone

(217) 383-0157

NPI assigned

Apr 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Soaring Eagles Counseling LLC

  • Professional Counselor
  • Champaign, IL
  • NPI 1518449958
  NPD Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585958400000",
    "number": "1043434061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 BLOOMINGTON RD STE 214",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618202560",
            "telephone_number": "217-383-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 BLOOMINGTON RD STE 214",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618202560",
            "telephone_number": "217-383-0157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 W University Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618203915",
            "country_code": "US",
            "telephone_number": "217-800-2182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTINE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-04-04",
        "certification_date": "2020-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180-002794",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180-002794",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-002794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCPC LICENSURE",
            "identifier": "180-002794",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• JL Dental Group LLC
• Terrance Richard Jobin, LCSW
• Tiffany Renee Johnson-Bey
• Beth A Johnson, MA CCC SLP L
• Carolyn Nicole Johnson, LSW
• Clifford Johnson Jr.
• Hailey Johnson, BCBA
• Heather Johnson, LCSW
• Heather Marie Johnson, DT
• Joy Johnson, CNP

• Professional Counselor in Champaign, IL
• Providers in Champaign, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2020; 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.