Fantasia Johnson, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C012194 Issued in NC

Practice address

8045 Arco Corporate Dr Ste 120
Raleigh, NC 27617-2026

Phone

(919) 372-3690

NPI assigned

Sep 2, 2015

Sex

Female

Sole proprietor

Yes

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

Enrolled in NC

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Global Counseling Solutions, PLLC

  • Clinical Social Worker
  • Durham, NC
  • NPI 1902212624
  Medicare reassignment NPD
• Nellie Health PLLC

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1194595512
  NPD
• Structured Family Interventions, LLC

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1528281425
  NPD (past)
• Structured Family Interventions, LLC

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1710289541
  NPD (past)

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1265800627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 SUMMER STORM DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277046227",
            "telephone_number": "919-599-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8045 ARCO CORPORATE DR STE 120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276172026",
            "telephone_number": "919-372-3690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6011 Fayetteville Rd",
            "address_2": "suite 104-C",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277136248",
            "country_code": "US",
            "telephone_number": "919-416-0800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "FANTASIA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Baynes Johnson, LCMHC-A
• Emily Grace Johnson, BS
• Erik Johnson
• Euphemia Laree Johnson, DDS, MS
• Fajr Amina Johnson
• Gabriel Ladsanda Johnson
• Gloria Asuquo Johnson, PHARMD
• Hannah Johnson
• Hannah Joyce Johnson, MS, LCMHCA, NCC
• Heather Carnago Johnson, RPH

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.