Taij Mallory Johnson, LPCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A10111 Issued in NC

Practice address

1306 Paddock Dr
Ste E-100
Raleigh, NC 27609-4873

Phone

(919) 790-7775

NPI assigned

Aug 29, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mr. Taij Johnson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1295169902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 MCNEILL ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283585140",
            "telephone_number": "910-474-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 PADDOCK DR",
            "address_2": "STE E-100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094873",
            "telephone_number": "919-790-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAIJ",
        "middle_name": "MALLORY",
        "name_prefix": "Mr.",
        "credential": "LPCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-29",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "A10111",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A10111",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A10111",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAIJ",
            "last_name": "JOHNSON",
            "prefix": "MR.",
            "credential": "LPCA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shaniece Johnson
• Shaughnessy Burnett Johnson
• Shelby Johnson
• Sherry Tang Johnson, M.D.
• Sonia Lynee Johnson
• Teilexis Rajene' Brichel Johnson
• Timisha Mercedes Johnson
• Traci Yvette Johnson, LCMHC-A
• Tykeena Lee Johnson
• Valencia Meshay Johnson

• Mental Health Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; 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.