Innovative Lifestyle Network, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

INNOVATIVE LIFESTYLE NETWORK, LLC

Practice address

301 McCullough Dr Ste 400
Charlotte, NC 28262-1336

Phone

(704) 504-7274

Fax

(704) 919-5564

NPI assigned

Sep 11, 2019

Organization subpart

No

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

Authorized official

Name

Shanika Johnson, M.S, LPCNPI 1548638000

Title

Owner/Therapist

Phone

(704) 421-1330

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shanika Nicole Johnson, M.S, LPC

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1548638000
  NPD Authorized official

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1437709482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MCCULLOUGH DR STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621336",
            "telephone_number": "704-504-7274",
            "fax_number": "704-919-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MCCULLOUGH DR STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621336",
            "telephone_number": "704-504-7274",
            "fax_number": "704-919-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE LIFESTYLE NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-11",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHANIKA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "704-421-1330",
        "authorized_official_credential": "M.S, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Innovative Support Services, LLC

• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.