Organization
LYNDSEY JOHNSEN, LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDSEY JOHNSEN LCSW (LICENSED CLINICAL SOCIAL WORKER)
(815) 579-8350
Entity
Organization
Contact information
Practice address
901 E GROVE ST STE O, BLOOMINGTON, IL 61701-8539
(815) 579-8350
Mailing address
PO BOX 111, BLOOMINGTON, IL 61702-0111
(815) 579-8350
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
149016349
IL
Other
Enumeration date
03/22/2016
Last updated
04/17/2016
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