Shanice M Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C012725 Issued in NC

Practice address

110 N Corcoran St
Durham, NC 27701-5015

Phone

(919) 961-3867

NPI assigned

Aug 23, 2017

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

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.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634
  Medicare reassignment NPD
• Optum Behavioral Care of North Carolina, P.C.

  • Clinical Social Worker
  • Apex, NC
  • NPI 1841184306
  Medicare reassignment NPD
• Optum Behavioral Care of North Carolina, P.C.

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1861371718
  NPD
• Haven House Inc.

  • Counselor
  • Raleigh, NC
  • NPI 1811194285
  NPD (past)
• Haven House Services

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1770837536
  NPD (past)

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1356868145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N CORCORAN ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277015015",
            "telephone_number": "919-961-3867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N CORCORAN ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277015015",
            "telephone_number": "919-961-3867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 W Cabarrus St",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276031953",
            "country_code": "US",
            "telephone_number": "919-833-3312",
            "fax_number": "919-833-3512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHANICE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally R Johnson, MD
• Samuel Henry Johnson Jr., PHARMD, MPH
• Sandra J Johnson, FNP-C
• Sarah Elizabeth Johnson
• Sarah Ruth Johnson, MD
• Sheronda Johnson
• Susan Johnson, PTA
• Susan Kay Johnson, LCSW
• Taja M Johnson, MSW, LCSW-A
• Thea Victoria Jones Johnson

• Clinical Social Worker in Durham, NC
• Providers in Durham, 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 Jun 2, 2025; 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.