Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nisa Johnson

Individual provider Clinical Social Worker · NPI 1255716205

Nisa Johnson is a Clinical Social Worker in Normal, Illinois. Qualified in 2003, 23 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
23
Licensed in
IL
In the registry since
2015

Practice location Address checks out

1100 Beech St Bldg 10-1
Normal, IL 61761-1568
Phone: (309) 750-0415
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 149017179 (IL)

Record details

NPI number1255716205
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 20, 2015
Last updated in NPPESOctober 24, 2022
Certification dateOctober 24, 2022
Mailing address1100 Beech St Bldg 10-1, Normal, IL 61761-1568

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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