Nisa Johnson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149017179 Issued in IL

Practice address

1100 Beech St BLDG 10-1
Normal, IL 61761-1568

Phone

(309) 750-0415

NPI assigned

Jul 20, 2015

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Nisa Johnson Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Normal, IL
  • NPI 1295469559
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1255716205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BEECH ST BLDG 10-1",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617611568",
            "telephone_number": "309-750-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BEECH ST BLDG 10-1",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617611568",
            "telephone_number": "309-750-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149017179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Johann
• Johnson Chiropractic, SC
• Johnson Family Chiropractic
• Christopher F Johnson Jr.
• Joshua Lee Johnson, D.C.
• Ryan Michael Johnson, D.O.
• Kathleen Rhoda Johnston, OTR/L
• Abigail Jones, PTA
• Jeffrey Lynn Jones, DDS
• Julie Jones, CST-A

• Clinical Social Worker in Normal, IL
• Providers in Normal, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.