Individual provider Active NPI

Shaunte' Johnson

  • Mental Health Counselor
  • Greensboro, NC
National Provider Identifier
1023467602
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
315 E Washington St
Greensboro, NC 27401-2911
Phone
(336) 387-6161
NPI assigned
Jun 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

315 E Washington St
Greensboro, NC 27401-2911

Mailing address

902 Bonner Dr
Jamestown, NC 27282-8948

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231228002026 NC Practitioner - Mental Health Counselor 7618327974 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12408NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rejuve Counseling & Consulting PLLC Current Accepting new patients
Triad Counseling & Clinical Service LLC CurrentSince Oct 28, 2025 Accepting new patients
Healing Therapy Services Inc CurrentSince May 26, 2024 Accepting new patients
Second Chance Behavioral Health Mental Health Past Accepting new patients

Locations

5587 Garden Village Way
Ste D
Greensboro, NC 27410
Phone (336) 272-8090

204 Muirs Chapel Rd
Ste 122
Greensboro, NC 27410
Phone (336) 516-5758

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1023467602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 BONNER DR",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272828948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E WASHINGTON ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012911",
            "telephone_number": "336-387-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHAUNTE'",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.