Individual provider Active NPI

Ellen Marie Johnston, MA

  • Mental Health Counselor
  • Raeford, NC
National Provider Identifier
1639436686
Registry record updated Oct 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13322 Issued in NC
Practice address
632 W Prospect Ave
Raeford, NC 28376-2512
Phone
(910) 875-5590
Fax
(910) 875-5008
NPI assigned
Apr 16, 2012
Last updated
Oct 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2026

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 13322 NC Primary

Addresses

Primary practice location

632 W Prospect Ave
Raeford, NC 28376-2512

Mailing address

110 Deer Lodge CT
Raeford, NC 28376-5473
Phone (910) 875-5590

Other names 1

  • Ms. Ellen M. Zamansky Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131003469 NC Practitioner - Mental Health Counselor 5193178663 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LPC 1174AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Haymount Institute for Psychological Services, PLLC Mental Health CurrentSince Jan 17, 2024 Accepting new patients
Haymount Institute for Psychological Services, PLLC Mental Health CurrentSince Jan 17, 2024 Accepting new patients
Divine Wellness Therapeutic Center PLLC CurrentSince Oct 1, 2024 Accepting new patients
Az Center for Change Past Accepting new patients

Locations

806 Hay St
Fayetteville, NC 28305
Phone 9108607008117

3077 N Main St
Ste 201
Hope Mills, NC 28348
Phone (910) 275-5766

3507 Hill St
Hope Mills, NC 28348
Phone (910) 339-0901

131 W Edinborough Ave
Raeford, NC 28376
Phone (910) 848-1222

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792540800000",
    "number": "1639436686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 DEER LODGE CT",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283765473",
            "telephone_number": "910-875-5590",
            "fax_number": "910-875-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 W PROSPECT AVE",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283762512",
            "telephone_number": "910-875-5590",
            "fax_number": "910-875-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "13322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "ZAMANSKY",
            "middle_name": "M.",
            "prefix": "MS.",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raeford, NC

Sources for this page

Verify at the official NPI Registry.