Susan Davis Johnson, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133001627 Issued in VA

Practice address

1405 S Broad St
Winston Salem, NC 27127-2068

Phone

(855) 772-8847

NPI assigned

Feb 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mount Rogers Community Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wytheville, VA
  • NPI 1255365599
  NPD (past)

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1245863505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 TRAINING CENTER RD",
            "city": "HILLSVILLE",
            "state": "VA",
            "postal_code": "243435656",
            "telephone_number": "762-371-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 S BROAD ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271272068",
            "telephone_number": "855-772-8847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "752 Training Center Rd",
            "address_purpose": "LOCATION",
            "city": "Hillsville",
            "state": "VA",
            "postal_code": "243435656",
            "country_code": "US",
            "telephone_number": "762-371-3472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUSAN",
        "middle_name": "DAVIS",
        "name_prefix": "Mrs.",
        "credential": "LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-14",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133001627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamica Lonette Johnson
• Shaniya Octavia Johnson, LMBT
• Sharon P Johnson, LCAS, LCSW
• Sheila Simone Johnson, FNP
• Soren Morgan Johnson, M.D.
• Tashana Denise Johnson, CRNP
• Taylor Johnson
• Trivy Johnson, CERTIFIED HAIR LOSS
• Yavonne L Johnson, PA
• Curtis Brent Johnsrude, M.D.

• Behavior Analyst in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.