Provider Demographics
NPI:1326332818
Name:JOHNSON, KATHERINE K (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:K
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 WILEY RD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4354
Mailing Address - Country:US
Mailing Address - Phone:847-240-5080
Mailing Address - Fax:847-240-1977
Practice Address - Street 1:1305 WILEY RD
Practice Address - Street 2:SUITE 125
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4354
Practice Address - Country:US
Practice Address - Phone:847-240-5080
Practice Address - Fax:847-240-1977
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.006491101YP2500X
IL180.008746101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional