IndividualActive
Michael Blea
NPI 1457030165 · Clinical Social Worker · Johnsburg, IL
Provider details
- NPI number
- 1457030165
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 149.026204 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
4210 Ella Ln
Johnsburg, IL 60051-5433
Phone: (815) 995-0306
Approximate (ZIP-level) locationGet directions
Mailing address
4210 Ella Ln
Johnsburg, IL 60051-5433
Registry dates
- Enumerated
- 2023-07-12
- Last updated
- 2025-03-24
- Certified
- 2025-03-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.