Provider Demographics
NPI:1609530229
Name:JOHNNIES, ASHLEY MARIE (MSW/LCSW)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MARIE
Last Name:JOHNNIES
Suffix:
Gender:F
Credentials:MSW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3804 11TH ST
Mailing Address - Street 2:
Mailing Address - City:WINTHROP HARBOR
Mailing Address - State:IL
Mailing Address - Zip Code:60096-1461
Mailing Address - Country:US
Mailing Address - Phone:414-369-2331
Mailing Address - Fax:
Practice Address - Street 1:5465 GRAND AVE STE 101
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-4913
Practice Address - Country:US
Practice Address - Phone:414-502-6573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2025-06-10
Deactivation Date:2025-04-08
Deactivation Code:
Reactivation Date:2025-04-28
Provider Licenses
StateLicense IDTaxonomies
IL149029178101Y00000X, 101YP2500X, 1041C0700X
149029178101YM0800X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker