Provider Demographics
NPI:1992546949
Name:JOHNSON, HARMONI KIMBERLI
Entity type:Individual
Prefix:
First Name:HARMONI
Middle Name:KIMBERLI
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 DONOVAN DR
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:IL
Mailing Address - Zip Code:60417-1509
Mailing Address - Country:US
Mailing Address - Phone:708-518-9880
Mailing Address - Fax:
Practice Address - Street 1:3509 DONOVAN DR
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:IL
Practice Address - Zip Code:60417-1509
Practice Address - Country:US
Practice Address - Phone:708-518-9880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0270491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical