Provider Demographics
NPI:1396542197
Name:JOHNSON TURNER, LAVANGELA (LSW)
Entity type:Individual
Prefix:
First Name:LAVANGELA
Middle Name:
Last Name:JOHNSON TURNER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:LAVANGELA
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:1010 LAKE ST STE 503
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1010 LAKE ST STE 503
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1135
Practice Address - Country:US
Practice Address - Phone:708-888-0491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.112747104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker