| Doctor Name: | MR. ERIC T. JOHNSON |
| NPI Number: | 1417276031 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 149.011832 |
| Business Practice Address: | 710 N Webb Ave Reedsburg, WI - 539591149 |
| Business Phone Number: | 6085245151 |
| Business Fax Number: | 6085245353 |
| Mailing Address: | 2334 W Lawrence Ave, Suite 204 CHICAGO |
| State: | IL |
| Postal Code: | 606251948 |
| Phone Number: | 7734569379 |
| Fax Number: | 4434609379 |
| NPI Enumeration Date: | 05/21/2010 |
| NPI Last Update Date: | 02/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149.011832 |
| 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 |