Nisa Johnson
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 10-1Normal, IL 61761-1568
Phone: (309) 750-0415
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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 number | 1255716205 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | July 20, 2015 |
| Last updated in NPPES | October 24, 2022 |
| Certification date | October 24, 2022 |
| Mailing address | 1100 Beech St Bldg 10-1, Normal, IL 61761-1568 |
Medicare enrollment
| Medicare specialty | CLINICAL SOCIAL WORKER |
|---|---|
| Medical school | OTHER |
| Graduated | 2003 (23 years in practice) |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
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