Individual provider Active NPI

Wendy Angelina Johnston, LCSW-C

  • Clinical Social Worker
  • Bolivia, NC
National Provider Identifier
1689995680
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15890 Issued in MD
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

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231222000241 DC Practitioner - Clinical Social Worker 4789833641 Reassigns benefits to 1 organization
I20240325003511 NY Practitioner - Clinical Social Worker 4789833641

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

Verify at the official NPI Registry.