Individual provider Active NPI

Kanisha Nathasha Johnson, MA

  • Mental Health Counselor
  • Columbia, SC
National Provider Identifier
1679053011
Registry record updated Aug 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC015663 Issued in GA
Practice address
2000 Park St
Columbia, SC 29201-2011
Phone
(803) 386-8834
NPI assigned
Aug 15, 2018
Last updated
Aug 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 23271 NC
Mental Health Counselor 101YM0800X LPC015663 GA Primary
Professional Counselor 101YP2500X 9956 SC

Addresses

Primary practice location

2000 Park St
Columbia, SC 29201-2011

Mailing address

264 Kings CV
Locust Grove, GA 30248-3904
Phone (347) 205-7479

Other names 1

  • Kanisha Nathasha Alleyne Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20250919001331 SC Practitioner - Mental Health Counselor 2567966724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Jul 23, 2025 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

170 Meeting St
Ste 110
Charleston, SC 29401
Phone (704) 610-1304

Organizations & group practices 3

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": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786838400000",
    "number": "1679053011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 KINGS CV",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302483904",
            "telephone_number": "347-205-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PARK ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012011",
            "telephone_number": "803-386-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KANISHA",
        "middle_name": "NATHASHA",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2026-08-16",
        "certification_date": "2026-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "23271",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC015663",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "9956",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KANISHA",
            "last_name": "ALLEYNE",
            "middle_name": "NATHASHA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.