Individual provider Active NPI

John T Anderson II, LCMHC-A

  • Mental Health Counselor
  • Winston Salem, NC
National Provider Identifier
1578101069
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
15280 Issued in NC
Practice address
526 W 1St St
Winston Salem, NC 27101-3736
Phone
(336) 608-7977
NPI assigned
Dec 15, 2019
Last updated
May 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 15280 NC Primary

Addresses

Primary practice location

526 W 1St St
Winston Salem, NC 27101-3736

Mailing address

526 W 1St St
Winston Salem, NC 27101-3736
Phone (336) 608-7797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1576368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1578101069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 W 1ST ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013736",
            "telephone_number": "336-608-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 W 1ST ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013736",
            "telephone_number": "336-608-7977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_suffix": "II",
        "credential": "LCMHC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-15",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "15280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.