Nisa Johnson Counseling LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NISA JOHNSON COUNSELING LLC

Practice address

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

Phone

(309) 750-0415

NPI assigned

Jul 13, 2022

Last updated

Oct 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nisa Johnson, LCSWNPI 1255716205

Title

Licensed Clinical Social Worker

Phone

(309) 750-0415

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nisa Johnson

  • Clinical Social Worker
  • Normal, IL
  • NPI 1255716205
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1295469559",
    "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": {
        "organization_name": "NISA JOHNSON COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "NISA",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "309-750-0415",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Path Psychological Services
• Melissa Ann Newbill, LCSW
• Tyson Newson, ST
• Rebekah Nielsen
• Joel Nilles, D.O.
• Nona Fulk, M.D., S.C.
• Eric Roy Norell, O.D.
• Morgan Leigh Norkiewicz, MS, CCC-SLP/L
• Normal Bloomington Anesthesiologists, LTD
• Corey Norman, LPC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Normal, IL
• Providers in Normal, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.