Provider Demographics
NPI:1003406315
Name:JOHNSON, LILI (LICSW)
Entity type:Individual
Prefix:MRS
First Name:LILI
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:LILI
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CLINICIAN
Mailing Address - Street 1:441 21ST ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4705
Mailing Address - Country:US
Mailing Address - Phone:202-341-6761
Mailing Address - Fax:202-644-7024
Practice Address - Street 1:915 RHODE ISLAND AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-4153
Practice Address - Country:US
Practice Address - Phone:202-560-0349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000032251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical