Active NPI
Wendy Angelina Johnston, LCSW-C
- Clinical Social Worker
- Bolivia, NC
National Provider Identifier
1689995680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 15890
- Practice address
- 3727 Sunny Meadow LN NE
Bolivia, NC 28422-7004 - Phone
- (240) 920-8995
- NPI assigned
- Jun 14, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 15890 | MD | Primary |
| Clinical Social Worker | 1041C0700X | 097155 | NY |
Addresses
Primary practice location
3727 Sunny Meadow LN NE
Bolivia, NC 28422-7004
Mailing address
141 Parker St Ste 306
Maynard, MA 01754-2180
Phone (866) 991-2103
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1689995680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 PARKER ST STE 306",
"city": "MAYNARD",
"state": "MA",
"postal_code": "017542180",
"telephone_number": "866-991-2103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3727 SUNNY MEADOW LN NE",
"city": "BOLIVIA",
"state": "NC",
"postal_code": "284227004",
"telephone_number": "240-920-8995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "WENDY",
"middle_name": "ANGELINA",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-14",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "15890",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "097155",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bolivia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.