Individual
MS. ELIZABETH A JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, CADC, CODP
Contact information
Practice address
1 MARTIN CT, LYNWOOD, IL 60411-4610
(708) 663-5779
Mailing address
1 MARTIN CT, LYNWOOD, IL 60411-4610
(708) 663-5779
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20863
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J52522163814
DRIVERS LICENSE
IL
Enumeration date
09/03/2019
Last updated
11/27/2023
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