Tinesha Denise Johnson
Individual provider Active NPI Behavior Technician · Dolton, IL
NPI 1467085753 · NPPES record last updated Sep 10, 2020
Key facts
- NPI
- 1467085753
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 14840 Shepard Dr
Dolton, IL 60419-2467 - Phone
- (773) 449-0859
- NPI assigned
- Feb 15, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Functional Skills Group | Behavior Technician | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Developmental Therapist | 222Q00000X | |||
| Home Health Aide | 374U00000X | |||
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
14840 Shepard Dr
Dolton, IL 60419-2467
Mailing address
14840 Shepard Dr
Dolton, IL 60419-2467
Phone (773) 449-0859
Other providers in Dolton, IL
- Jaroslaus T Iwanetz MD SC
- Michelle Jenkins
- Nikkita Chennille Johnson-Neealy
- Quintella Johnson
- Roneisha C Johnson
- Yvette Johnson
- Chunita Jones
- Malherbe Joey Joseph
- Journey for Healthier Living
- Journey to the Stars, Inc
All providers in Dolton, IL · Behavior Technician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2020. 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.