Lisa Johnson, LCSW

Individual provider Active NPI Clinical Social Worker · Princeton, IL

NPI 1417375650 · NPPES record last updated Mar 25, 2021

Key facts

NPI: 1417375650
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: 149.011372 (IL)
Practice address: 28 E Marion St
Princeton, IL 61356-2093
Phone: (815) 875-2192
NPI assigned: Apr 4, 2014
Reactivated: Mar 25, 2021
Sex: Female
Sole proprietor: Yes

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.

New Directions Counseling Center Clinical Social Worker · Princeton, IL · NPI 1831729466

NPD CLINICAL

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
149.011372	IL	MD	Clinical Social Worker

Practice roles

Organization	Specialty	Status	New patients
New Directions Counseling Center	Clinical	Current	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	149.011372	IL	Yes

Addresses

Primary practice location

28 E Marion St
Princeton, IL 61356-2093

Mailing address

602 Grove St
Henry, IL 61537-1204
Phone (309) 714-0354

Other providers in Princeton, IL

All providers in Princeton, IL · Clinical Social Worker in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.