Individual provider Active NPI

Vetta Anne Love-Johnson, LCSW

  • Clinical Social Worker
  • Country Club Hills, IL
National Provider Identifier
1578994224
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015244 Issued in IL
Practice address
4533 177TH St
Country Club Hills, IL 60478-4506
Phone
(708) 206-0138
NPI assigned
Dec 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149015244 IL Primary

Addresses

Primary practice location

4533 177TH St
Country Club Hills, IL 60478-4506

Mailing address

4533 177TH St
Country Club Hills, IL 60478-4506
Phone (708) 206-0138

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149015244ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1578994224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4533 177TH ST",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604784506",
            "telephone_number": "708-206-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4533 177TH ST",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604784506",
            "telephone_number": "708-206-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVE-JOHNSON",
        "first_name": "VETTA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-06",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Country Club Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.