Provider Demographics
NPI:1275368342
Name:JOHNSON, BRIANNA (LSW)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 E ALGONQUIN RD STE 702
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4162
Mailing Address - Country:US
Mailing Address - Phone:847-701-4191
Mailing Address - Fax:847-834-4981
Practice Address - Street 1:3115 N WILKE RD STE A
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1451
Practice Address - Country:US
Practice Address - Phone:847-701-4191
Practice Address - Fax:847-834-4981
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.114228104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker