Provider Demographics
NPI:1477308047
Name:JOHNSON, FIONA CATHERINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:FIONA
Middle Name:CATHERINE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 VINEYARD LN
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5331
Mailing Address - Country:US
Mailing Address - Phone:847-571-1352
Mailing Address - Fax:
Practice Address - Street 1:1428 VINEYARD LN
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5331
Practice Address - Country:US
Practice Address - Phone:847-571-1352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0234871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical