Active NPI
Timothy Lee Johnson, M.A., LCAS
- Addiction (Substance Use Disorder) Counselor
- Charlotte, NC
National Provider Identifier
1437463742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCAS 1659
- Practice address
- 3100 Rhett CT
Charlotte, NC 28273-3660 - Phone
- (704) 579-0427
- NPI assigned
- Jul 28, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS 1659 | NC | Primary |
Addresses
Primary practice location
3100 Rhett CT
Charlotte, NC 28273-3660
Mailing address
3100 Rhett CT
Charlotte, NC 28273-3660
Phone (704) 579-0427
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6112183 | Medicaid | NC |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCAS 1659 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293580800000",
"number": "1437463742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 RHETT CT",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282733660",
"telephone_number": "704-579-0427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 RHETT CT",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282733660",
"telephone_number": "704-579-0427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "TIMOTHY",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "M.A., LCAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-28",
"last_updated": "2010-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS 1659",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6112183",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.