Provider Demographics
NPI:1689356644
Name:WINTER-HARPER, JOHANNA MAIRIN (MFT)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:MAIRIN
Last Name:WINTER-HARPER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 N RAVENSWOOD AVE APT 1N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-4415
Mailing Address - Country:US
Mailing Address - Phone:773-301-4695
Mailing Address - Fax:
Practice Address - Street 1:105 N OAK PARK AVE # 1N
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1364
Practice Address - Country:US
Practice Address - Phone:773-301-4695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist