Individual provider Active NPI

Kristy Johnstone, LCSW

  • Clinical Social Worker
  • Downers Grove, IL
National Provider Identifier
1285050609
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.014961 Issued in IL
Practice address
515 Ogden Ave
Suite 304
Downers Grove, IL 60515-3071
Phone
(630) 674-2657
NPI assigned
Mar 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.014961 IL Primary

Addresses

Primary practice location

515 Ogden Ave
Suite 304
Downers Grove, IL 60515-3071

Mailing address

515 Ogden Ave
Suite 304
Downers Grove, IL 60515-3071
Phone (630) 674-2657

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

LicenseStateTypeSpecialty
149.014961ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tender Hearts Therapy, LTD Clinical CurrentSince Aug 2, 2020 Accepting new patients

Locations

5201 Washington St
Ste 4
Downers Grove, IL 60515
Phone (630) 674-2657

Organizations & group practices 1

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": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1285050609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 OGDEN AVE",
            "address_2": "SUITE 304",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153071",
            "telephone_number": "630-674-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 OGDEN AVE",
            "address_2": "SUITE 304",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153071",
            "telephone_number": "630-674-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTONE",
        "first_name": "KRISTY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.