Individual provider Active NPI

Toya Elaine Johnson, LCSW

  • Clinical Social Worker
  • Burnham, IL
National Provider Identifier
1952708299
Registry record updated Nov 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149016274 Issued in IL
Practice address
14526 S Muskegon Ave Apt 3a
Burnham, IL 60633-2084
Phone
(309) 287-3942
NPI assigned
Dec 2, 2014
Last updated
Nov 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 149016274 IL
Clinical Social Worker 1041C0700X 149016274 IL Primary

Addresses

Primary practice location

14526 S Muskegon Ave Apt 3a
Burnham, IL 60633-2084

Mailing address

14526 S Muskegon Ave Apt 3a
Burnham, IL 60633-2084
Phone (309) 287-3942

Other identifiers 1

IdentifierTypeStateIssuer
149016274OtherILLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230830000624 IL Practitioner - Clinical Social Worker 7214390897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

20550 S Lagrange Rd
Suite 105
Frankfort, IL 60423-1273
Phone (888) 428-7890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149016274ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. Clinical CurrentSince Aug 7, 2023 Accepting new patients
Psychology Specialists LTD Counselor Past Accepting new patients

Locations

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

20550 S Lagrange Rd
Ste 105
Frankfort, IL 60423
Phone (708) 448-3300

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

3027 English Rows Ave
Ste 201
Naperville, IL 60564

433 Landings Dr
Ste A
New Lenox, IL 60451

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730505600000",
    "number": "1952708299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14526 S MUSKEGON AVE APT 3A",
            "city": "BURNHAM",
            "state": "IL",
            "postal_code": "606332084",
            "telephone_number": "309-287-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14526 S MUSKEGON AVE APT 3A",
            "city": "BURNHAM",
            "state": "IL",
            "postal_code": "606332084",
            "telephone_number": "309-287-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TOYA",
        "middle_name": "ELAINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-02",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "149016274",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149016274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "149016274",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnham, IL

Sources for this page

Verify at the official NPI Registry.