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Organization
INTERTWINED
Active
Organization
INTERTWINED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROCHELLE JOHNSON LCSW (OWNER)
(708) 499-2030
Entity
Organization
Contact information
Practice address
10540 S WESTERN AVE STE 103, CHICAGO, IL 60643-2541
(708) 499-2030
Mailing address
10540 S WESTERN AVE STE 103, CHICAGO, IL 60643-2541
(708) 499-2030
(708) 634-3688
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180005742
IL
1041C0700X
Clinical Social Worker
Primary
149011142
IL
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
02/13/2010
Last updated
03/17/2025
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