Active NPI
Roberta Johnson, LCAS-A
- Addiction (Substance Use Disorder) Counselor
- Charlotte, NC
National Provider Identifier
1548993652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 27667
- Practice address
- 5601 Executive Center Dr
Charlotte, NC 28212-8863 - Phone
- (704) 537-1022
- NPI assigned
- Jul 6, 2022
- Sex
- Female
- 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 | 27667 | NC | Primary |
Addresses
Primary practice location
5601 Executive Center Dr
Charlotte, NC 28212-8863
Mailing address
5601 Executive Center Dr
Charlotte, NC 28212-8863
Phone (704) 891-7366
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
| License | State | Type | Specialty |
|---|---|---|---|
| 27667 | 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": "1657065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657670400000",
"number": "1548993652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5601 EXECUTIVE CENTER DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282128863",
"telephone_number": "704-891-7366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5601 EXECUTIVE CENTER DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282128863",
"telephone_number": "704-537-1022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ROBERTA",
"credential": "LCAS-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-06",
"last_updated": "2022-07-13",
"certification_date": "2022-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "27667",
"primary": true
}
],
"identifiers": [],
"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 Jul 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.