Individual provider Active NPI

Edward Angus Johnston, M.S., LPC, LCAS

  • Professional Counselor
  • Greenville, NC
National Provider Identifier
1457580847
Registry record updated Jul 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7472 Issued in NC
Practice address
704 Cromwell Dr
Suite B
Greenville, NC 27858-5894
Phone
(252) 341-4902
Fax
(252) 355-7947
NPI assigned
Jul 7, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1486 NC
Professional Counselor 101YP2500X 7472 NC Primary
Mental Health Counselor 101YM0800X 7472 NC

Addresses

Primary practice location

704 Cromwell Dr
Suite B
Greenville, NC 27858-5894

Mailing address

316 Mary Lee CT
Winterville, NC 28590-9917
Phone (252) 341-4902

Other identifiers 1

IdentifierTypeStateIssuer
6104227OtherNCMEDICAID

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 Science

State licenses

LicenseStateTypeSpecialty
1486NCMDAddiction (Substance Use Disorder) Counselor
7472NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374969600000",
    "number": "1457580847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 MARY LEE CT",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909917",
            "telephone_number": "252-341-4902",
            "fax_number": "252-355-7947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 CROMWELL DR",
            "address_2": "SUITE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585894",
            "telephone_number": "252-341-4902",
            "fax_number": "252-355-7947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "EDWARD",
        "middle_name": "ANGUS",
        "name_prefix": "Mr.",
        "credential": "M.S., LPC, LCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2013-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1486",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "7472",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "7472",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "6104227",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2013; 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.