Johnson, Edria

Johnson, Edria is an individual health care provider with primary practice located at 4801 Southwick Dr Ste 300 , Matteson IL 60443-2279. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Johnson, Edria can be contacted via phone (708) 945-2647.

Contact Information

Primary practice address
4801 Southwick Dr Ste 300 Matteson IL 60443-2279
Phone: (708) 945-2647
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X Illinois
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1346664372
LBN Legal business name Johnson, Edria
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 11th, 2014
Last updated Jun 7th, 2023 - about last year

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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