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Organization
NEUROTECHTONICS INC NFP
Active
Organization
NEUROTECHTONICS INC NFP
Active
Other names
NEUROTECHTONICS INC NFP
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN AUBREY JOHNSON LCPC, LPHA (CLINICAL SUPERVISOR)
(708) 200-0034
Entity
Organization
Contact information
Practice address
4350 211TH ST STE 210A, MATTESON, IL 60443-3082
(708) 833-7939
Mailing address
1213 BLACKHAWK DR STE 210A, UNIVERSITY PARK, IL 60484-3321
(708) 200-0034
(708) 833-7939
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
03/17/2023
Last updated
02/15/2024
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