Individual provider Active NPI

Jhane' Hadiya Johnson, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Cary, NC
National Provider Identifier
1316548233
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1903 N Harrison Ave Ste 200
Cary, NC 27513-3093
Phone
(919) 218-4211
Fax
(877) 292-0656
NPI assigned
Nov 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary
Social Worker 104100000X 0906009697 VA

Addresses

Primary practice location

1903 N Harrison Ave Ste 200
Cary, NC 27513-3093

Mailing address

200 Great Ridge CT
Morrisville, NC 27560-6788
Phone (919) 218-4211

Other identifiers 3

IdentifierTypeStateIssuer
LCAS26321OtherNCNC STATE LICENSE
0906009697OtherVASUPERVISEE LICENSE
0734001439OtherVATRAINEE MENTAL HEALTH PROFESSIONAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL WakeCounty Direct

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
0906009697VAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pivotal Point Solution Social Worker CurrentSince Aug 1, 2020 Accepting new patients

Locations

1903 N Harrison Ave
Ste 200
Cary, NC 27513
Phone (919) 218-4211

1903 N Harrison Ave
Cary, NC 27513
Phone (919) 772-1990

Organizations & group practices 1

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": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1316548233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GREAT RIDGE CT",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275606788",
            "telephone_number": "919-218-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 N HARRISON AVE STE 200",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133093",
            "telephone_number": "919-218-4211",
            "fax_number": "877-292-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JHANE'",
        "middle_name": "HADIYA",
        "credential": "LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "0906009697",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE LICENSE",
            "identifier": "LCAS26321",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERVISEE LICENSE",
            "identifier": "0906009697",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINEE MENTAL HEALTH PROFESSIONAL",
            "identifier": "0734001439",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "WakeCounty",
            "affiliation": "N",
            "endpointDescription": "Location of Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "County of Office",
            "address_1": "1903 N Harrison Ave",
            "city": "Cary",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275133092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.