Edria Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

4801 Southwick Dr Ste 300
Matteson, IL 60443-2279

Phone

(708) 945-2647

NPI assigned

Feb 11, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1346664372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20015 S LAGRANGE RD # 1450",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233104",
            "telephone_number": "708-945-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 SOUTHWICK DR STE 300",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432279",
            "telephone_number": "708-945-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EDRIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-11",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Treacie Gill Jelks
• Brittney M Jeter, LPN
• JK&D Transportation, Inc.
• Zahraa Jody
• David Allen Johnson, MSW, LCSW, LCAC,MAC
• Joy Johnson, LPCC
• Steven Jones-Denson
• Brittany Jones, LSW
• Brittney Jones, MOTR/L
• Dorothy M Jones, MD

• Clinical Social Worker in Matteson, IL
• Providers in Matteson, 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 Jun 7, 2023; 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.