Individual provider Active NPI

Ava Johnson, LPCA

  • Mental Health Counselor
  • Durham, NC
National Provider Identifier
1114568425
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A15254 Issued in NC
Practice address
2009 Chapel Hill Rd
Durham, NC 27707-1109
Phone
(919) 391-0446
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A15254 NC Primary

Addresses

Primary practice location

2009 Chapel Hill Rd
Durham, NC 27707-1109

Mailing address

1512 Milton Rd
Durham, NC 27712-1527
Phone (919) 357-0744

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
A15254NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1114568425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 MILTON RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277121527",
            "telephone_number": "919-357-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 CHAPEL HILL RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277071109",
            "telephone_number": "919-391-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AVA",
        "credential": "LPCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.