Shelly Johnson Jr.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC013070 Issued in GA

Practice address

1 Freedom Way
Augusta, GA 30904-6258

Phone

(706) 733-0188

NPI assigned

Sep 1, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1609596360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 NORMANDY PL",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309092029",
            "telephone_number": "706-799-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "706-733-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHELLY",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC013070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Johnson
• Scott Bradley Johnson
• Shakeitrice Stokes Johnson, MA, CCC-SLP
• Shaneka Johnson
• Shauntae McLamore Johnson, PHYSICIAN ASST CERTI
• Stephanie Whitaker Johnson, MHS, OTR/L
• Taneshia Johnson
• Terrance Johnson, MD
• Theodore Samuel Johnson, M.D., PH.D.
• Tiffany Alexis Johnson, MSW, LCSW

• Mental Health Counselor in Augusta, GA
• Providers in Augusta, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.

Verify at the official NPI Registry.