Active NPI
Kristie M. Johnson, LCPC CADC CADP
- Professional Counselor
- Naperville, IL
National Provider Identifier
1184879942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-006864
- Practice address
- 1568 Clyde Dr.
Naperville, IL 60565 - Phone
- (630) 961-2530
- NPI assigned
- Nov 20, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CADC15624 | IL | |
| Professional Counselor | 101YP2500X | 180-006864 | IL | Primary |
Addresses
Primary practice location
1568 Clyde Dr.
Naperville, IL 60565
Mailing address
1568 Clyde Dr.
Naperville, IL 60565
Phone (630) 961-2530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CADC15624 | IL | MD | Addiction (Substance Use Disorder) Counselor |
| 180-006864 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227139200000",
"number": "1184879942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1568 CLYDE DR.",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "60565",
"telephone_number": "630-961-2530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1568 CLYDE DR.",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "60565",
"telephone_number": "630-961-2530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KRISTIE",
"middle_name": "M.",
"name_prefix": "Mrs.",
"credential": "LCPC CADC CADP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-20",
"last_updated": "2008-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IL",
"license": "CADC15624",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-006864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.