Individual provider Active NPI

Melanie Johnson, LMFT

  • Marriage & Family Therapist
  • Crystal Lake, IL
National Provider Identifier
1679833487
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166.000967 Issued in IL
Practice address
600 Dakota St
Suite B
Crystal Lake, IL 60012-3742
Phone
(847) 220-8428
NPI assigned
May 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166.000967 IL Primary

Addresses

Primary practice location

600 Dakota St
Suite B
Crystal Lake, IL 60012-3742

Mailing address

600 Dakota St
Suite B
Crystal Lake, IL 60012-3742
Phone (847) 220-8428

Other practice location 1

12555 Farm Hill Dr Ste 900
Huntley, IL 60142-7723
Phone (847) 220-8428

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
166.000967ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Hope Counseling Center LTD Marriage & Family Therapist CurrentSince Aug 17, 2025 Accepting new patients
Blair Counseling and Mediation PC Marriage & Family Therapist PastSince Jan 19, 2025 Accepting new patients

Locations

600 Dakota St
Ste B
Crystal Lake, IL 60012
Phone (815) 276-3947

27 Grant St
Crystal Lake, IL 60014
Phone (815) 276-3947

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1679833487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 DAKOTA ST",
            "address_2": "SUITE B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123742",
            "telephone_number": "847-220-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 DAKOTA ST",
            "address_2": "SUITE B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123742",
            "telephone_number": "847-220-8428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12555 Farm Hill Dr Ste 900",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601427723",
            "country_code": "US",
            "telephone_number": "847-220-8428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MELANIE",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.000967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.