Individual
CICELY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6115 S DAMEN AVE, CHICAGO, IL 60636-2132
(773) 744-3688
Mailing address
6115 S DAMEN AVE, CHICAGO, IL 60636-2132
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149017362
IL
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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