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Organization

NISA JOHNSON COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NISA JOHNSON LCSW (LICENSED CLINICAL SOCIAL WORKER)
(309) 750-0415
Entity
Organization

Contact information

Practice address
1100 BEECH ST BLDG 10-1, NORMAL, IL 61761-1568
(309) 750-0415
Mailing address
1100 BEECH ST BLDG 10-1, NORMAL, IL 61761-1568
(309) 750-0415

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
07/13/2022
Last updated
10/26/2022
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