Shalonda Johnson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P021490 Issued in NC

Practice address

50 Tun Tavern Dr
Cameron, NC 28326-5523

Phone

(910) 354-8731

NPI assigned

Feb 12, 2025

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

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.

• Verna Dority, MSW, CCSW, Inc

  • Community/Behavioral Health Agency
  • Fayetteville, NC
  • NPI 1396984225

  Clinical

  NPD

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

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1740095066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6321 RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283042810",
            "telephone_number": "910-485-6336",
            "fax_number": "888-972-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 TUN TAVERN DR",
            "city": "CAMERON",
            "state": "NC",
            "postal_code": "283265523",
            "telephone_number": "910-354-8731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHALONDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P021490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Jankowski, PA-C
• Ashley Nicole Jimenez, NP-C
• Arielle Johnson
• Audrey Renee Johnson
• Madeline Johnson
• Kimberlee Johnston
• Kirsti Erin Johnston, FNP
• Amanda Jones
• Brittney Michelle Judd
• Olivia Juergens

• Clinical Social Worker in Cameron, NC
• Providers in Cameron, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.