Individual provider Active NPI

Cortrina Lynn Johnson, MSW/LCASA

  • Addiction (Substance Use Disorder) Counselor
  • High Point, NC
National Provider Identifier
1053647891
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2792A Issued in NC
Practice address
1001 Phillips Ave
High Point, NC 27262-7251
Phone
(910) 670-7119
NPI assigned
Oct 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P005376 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X 2792A NC Primary

Addresses

Primary practice location

1001 Phillips Ave
High Point, NC 27262-7251

Mailing address

85 Hallow Oak St
Spring Lake, NC 28390-9811
Phone (910) 670-7119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2792ANCMDAddiction (Substance Use Disorder) Counselor
P005376NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1053647891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HALLOW OAK ST",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283909811",
            "telephone_number": "910-670-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 PHILLIPS AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627251",
            "telephone_number": "910-670-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CORTRINA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MSW/LCASA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-29",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P005376",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "2792A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.