Lisa Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.011372 Issued in IL

Practice address

28 E Marion St
Princeton, IL 61356-2093

Phone

(815) 875-2192

NPI assigned

Apr 4, 2014

Reactivated

Mar 25, 2021

Last updated

Mar 25, 2021By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Directions Counseling Center

  • Clinical Social Worker
  • Princeton, IL
  • NPI 1831729466
  NPD Authorized official

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1417375650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 GROVE ST",
            "city": "HENRY",
            "state": "IL",
            "postal_code": "615371204",
            "telephone_number": "309-714-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 E MARION ST",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613562093",
            "telephone_number": "815-875-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-04",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "deactivation_date": "2021-03-02",
        "reactivation_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ihcc LLC (In-Home Care Connection)
• Illinois Rural Community Care Organization
• Venkata C Jampala, MD
• Jeffrey D Dzik OD & Associates LLC
• Jacquelyn Johnson, OTR/L
• Journeys Counseling Assoc Inc
• Julia Rackley Perry Memorial Hospital (Perry Memorial Hospital)
• Julia Rackley Perry Memorial Hospital (Perry Memorial Prompt Care)
• Julia Rackley Perry Memorial Hospital (Perry Memorial Orthopedic & Sports Medicine)
• Julia Rackley Perry Memorial Hospital (Perry Memorial General Surgery Clinic)

• Clinical Social Worker in Princeton, IL
• Providers in Princeton, 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 Mar 25, 2021; 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.