Johnson, Melissa M

Johnson, Melissa M is an individual health care provider with primary practice located at 12 Health Services Dr , Dekalb IL 60115-9637. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Johnson, Melissa M can be contacted via phone (815) 756-4875.

Contact Information

Primary practice address
12 Health Services Dr Dekalb IL 60115-9637
Phone: (815) 756-4875
Fax: (815) 756-2944
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149.021116 Illinois
Behavioral Health & Social Service Providers / Social Worker 104100000X 149.021116 Illinois

Profile Details

NPI number 1437535929
LBN Legal business name Johnson, Melissa M
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 6th, 2015
Last updated Oct 21st, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437535929 NPPES
Illinois MEDICAID 362771343001

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