Individual provider Active NPI

Tanganeka Monique Johnston, LCSWA

  • Clinical Social Worker
  • Salisbury, NC
National Provider Identifier
1154861797
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P015779 Issued in NC
Practice address
Shyas Cares 714 S. Main St.
Salisbury, NC 28144
Phone
(704) 603-8285
Fax
(704) 353-7901
NPI assigned
Mar 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P011242 NC
Clinical Social Worker 1041C0700X P015779 NC Primary

Addresses

Primary practice location

Shyas Cares 714 S. Main St.
Salisbury, NC 28144

Mailing address

Shyas Cares 714 S. Main St.
Salisbury, NC 28144
Phone (704) 603-8285

Other identifiers 1

IdentifierTypeStateIssuer
562546907MedicaidNC

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
P011242NCMDMental Health Counselor
P015779NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
S&H Youth and Adult Services, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Arj SC Past Accepting new patients
Arj, LLC PastSince Jun 27, 2017 Accepting new patients

Locations

714 S Main St
Salisbury, NC 28144
Phone (704) 603-8285

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1154861797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SHYAS CARES 714 S. MAIN ST.",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "28144",
            "telephone_number": "704-603-8285",
            "fax_number": "704-353-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SHYAS CARES 714 S. MAIN ST.",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "28144",
            "telephone_number": "704-603-8285",
            "fax_number": "704-353-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "TANGANEKA",
        "middle_name": "MONIQUE",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-01",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "P011242",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P015779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "562546907",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.