Doctor Name: | JENNIFER J. JOHNSTON |
NPI Number: | 1003931619 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.S.W. |
License Number: | 149012075 |
Business Practice Address: | 977 Lakeview Parkway Suite 180 Vernon Hills, IL - 60061 |
Business Phone Number: | 8474018205 |
Business Fax Number: | 8475497005 |
Mailing Address: | 505 E Shorewood Dr, ROUND LAKE BEACH |
State: | IL |
Postal Code: | 600732273 |
Phone Number: | 8477401905 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2007 |
NPI Last Update Date: | 08/11/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149012075 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |