Individual
CHRISTINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
702 BLOOMINGTON RD STE 214, CHAMPAIGN, IL 61820-2560
(217) 383-0157
Mailing address
702 BLOOMINGTON RD STE 214, CHAMPAIGN, IL 61820-2560
(217) 383-0157
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
180-002794
IL
101YM0800X
Mental Health Counselor
180-002794
IL
101YP2500X
Professional Counselor
Primary
180-002794
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180-002794
LCPC LICENSURE
IL
Enumeration date
04/12/2007
Last updated
04/04/2020
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