Harmoni Kimberli Johnson

Individual provider Active NPI Clinical Social Worker · Crete, IL

NPI 1992546949 · NPPES record last updated Jun 4, 2024

Key facts

NPI
1992546949
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149.027049 (IL)
Practice address
3509 Donovan Dr
Crete, IL 60417-1509
Phone
(708) 518-9880
NPI assigned
Jun 4, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
149.027049ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.027049 IL Yes

Addresses

Primary practice location

3509 Donovan Dr
Crete, IL 60417-1509

Mailing address

3509 Donovan Dr
Crete, IL 60417-1509
Phone (708) 518-9880

Other providers in Crete, IL

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

Sources for this page

Verify at the official NPI Registry.