Individual provider Active NPI

Ashley Johnson

  • Clinical Social Worker
  • Goldsboro, NC
National Provider Identifier
1114545662
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P014616 Issued in NC
Practice address
1700 E Ash St Ste 201
Goldsboro, NC 27530-4097
Phone
(919) 736-6720
NPI assigned
Jul 10, 2020
Last updated
Jul 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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 26432 NC
Clinical Social Worker 1041C0700X P014616 NC Primary

Addresses

Primary practice location

1700 E Ash St Ste 201
Goldsboro, NC 27530-4097

Mailing address

865 Kingold Blvd Apt U
Snow Hill, NC 28580-1670
Phone (252) 290-5588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240205004177 SC Practitioner - Clinical Social Worker 1153773460 Reassigns benefits to 1 organization
I20240220000449 NC Practitioner - Clinical Social Worker 1153773460 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26432NCMDAddiction (Substance Use Disorder) Counselor
578SCMDClinical Psychologist
P014616NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Restorative Care Services, LLC CurrentSince May 16, 2022 Accepting new patients
Restorative Care Services, LLC CurrentSince Jan 4, 2026 Accepting new patients
Premier Counseling Clinical CurrentSince Jan 1, 2024 Accepting new patients

Locations

4711 Forest Dr
Ste 3
Columbia, SC 29206
Phone (404) 218-9006

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1114545662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 KINGOLD BLVD APT U",
            "city": "SNOW HILL",
            "state": "NC",
            "postal_code": "285801670",
            "telephone_number": "252-290-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E ASH ST STE 201",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304097",
            "telephone_number": "919-736-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ASHLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "26432",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

Verify at the official NPI Registry.