HEATHER JOHNSON (NPI# 1417596685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417596685 |
| Entity Type | Individual |
| Full Name | HEATHER JOHNSON |
| Other Name | HEATHER RENEE CLARK |
| Credential | LCSW |
| Practice Address |
1815 Crescent Dr Champaign IL 61821-5829 |
| Practice Telephone | 8476305727 |
| Mailing Telephone | 8476305727 |
| Enumeration Date | 2020-01-05 |
| Last Update Date | 2020-01-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149019577 | IL | Behavioral Health & Social Service Providers |
| N | 1041S0200X |
Social Worker Specialization: School |
995540 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | CLINICAL SOCIAL WORK LICENSE | 149019577 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023621760 | Heather Nicole Johnson | Nurse Practitioner | 13486 Springhill Ct Apt Suite, Winnebago, IL 61088-8054 | 2020-08-24 |
| 1538633284 | Heather Allison Johnson | Registered Nurse | 1009 Terry Ranch Rd, Cheyenne, WY 82007-9708 | 2019-01-16 |
| 1457820706 | Heather Blythe Johnson | Occupational Therapy Assistant | 15620 Opal Fire Dr, Austin, TX 78728-3655 | 2018-11-15 |
| 1235605270 | Heather Renee Johnson | Nurse Practitioner | 6699 Corte Maria, Carlsbad, CA 92009-5917 | 2018-10-17 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1275049249 | Heather Rose Johnson | Early Intervention Provider Agency | 166 Centre Ave, Middleboro, MA 02346-2053 | 2017-12-28 |
| 1508387937 | Heather A Johnson | Massage Therapist | 3041 Aldrich Ave S, Minneapolis, MN 55408-2802 | 2017-07-06 |
| 1700251246 | Heather Johnson | Behavioral Analyst | 390 Mac Arthur Blvd, Hauppauge, NY 11788-3057 | 2015-12-09 |
| 1467834978 | Heather Lee Johnson | Registered Nurse | 2406 Buckhorn Ave, Schofield, WI 54476-5145 | 2015-06-19 |
| 1245629310 | Heather Johnson | Social Worker | 5535 Teaberry Rd, Riverside, CA 92505-2441 | 2015-01-13 |
| Street Address |
1815 CRESCENT DR |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61821-5829 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326532888 | Cunningham Children's Home of Urbana Il | Residential Treatment Facility, Emotionally Disturbed Children | 1303 N. Cunningham Avenue, Urbana, IL 61821 | 2018-06-19 |
| 1184008708 | Seunghyun Jae | Dentist | 1905 W Springfield Ave, Champaign, IL 61821 | 2015-07-14 |
| 1457698169 | Mohamad Ata | Registered Nurse | 1802 S. Mattis, Champaign, IL 61821 | 2013-01-15 |
| 1609124338 | Lolitia Rosanna Newman | Social Worker | 1508 Powers Ln., Champaign, IL 61821 | 2012-08-28 |
| 1679850887 | Kirk Donald Gohsman | Counselor | 106 S. Country Fair Drive, Suite C, Champaign, IL 61821 | 2011-11-16 |
| 1598054777 | Delbert William Nelson Jr. | Psychiatry & Neurology | 2115 Galen Dr, Champaign, IL 61821 | 2011-03-28 |
| 1790946929 | Rdi Vein LLC | Clinic/Center | 2502 Galen Drive, Suite 101, Champaign, IL 61821 | 2008-06-20 |
| 1366620064 | Advanced Aesthetics Surgery & Laser Center, P.C. | Clinic/Center | 2111 West Park Ct., Champaign, IL 61821 | 2008-02-05 |
| 1033398482 | Huey's Home Medical, Inc | Durable Medical Equipment & Medical Supplies | 1207 S Mattis Ave Ste 1, Champaign, IL 61821 | 2007-11-01 |
| 1265630537 | Elizabeth Catherine Tingley | Psychologist | Department of Psychiatry and Psychology-carle Physician, 1802 S. Mattis, Champaign, IL 61821 | 2007-07-06 |
| Find all providers in zip 61821 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336759620 | Telos Health and Wellness Services, LLC | Social Worker | 907 W Marketview Dr Ste 10, Champaign, IL 61822-1250 | 2020-08-03 |
| 1255963583 | Jamey Richard Bailey | Social Worker | 701 Devonshire Drive, Bldg C, Suite 206, C-6, Champaign, IL 61820 | 2020-02-05 |
| 1932730835 | Katina Wilcher | Social Worker | 609 Crestwood Dr, Champaign, IL 61822-7369 | 2020-01-29 |
| 1518425230 | Kc Counseling, LLC | Social Worker | 206 N Randolph St Ste 508, Champaign, IL 61820-3949 | 2019-03-12 |
| 1134692536 | Felicia Huiyan Li | Social Worker | 3115 Village Office Pl, Champaign, IL 61822-7673 | 2019-01-08 |
| 1528575958 | David H. Crowley and Associates Ltd | Social Worker | 100 N Chestnut St Ste 231, Champaign, IL 61820-4856 | 2018-01-08 |
| 1356850457 | Jessica L Wiley | Social Worker | 701 Devonshire Dr Ste B16-18, Champaign, IL 61820-7337 | 2017-09-21 |
| 1821518127 | Molly Mclay | Social Worker | 309 W Clark St., Champaign, IL 61820 | 2017-06-27 |
| 1770938359 | Champaign Counseling LLC | Social Worker | 313 N Mattis Ave Ste 209, C/o Erik Olson, Champaign, IL 61821-2461 | 2016-05-02 |
| 1962874495 | Luciana Angelica Guardini | Social Worker | 100 North Chestnut Street, Suite 244, Champaign, IL 61820 | 2015-10-23 |
| Find all providers in CHAMPAIGN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.