Charryse Johnson, MA, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

11709 Issued in NC

Practice address

5970 Fairview Rd Ste 420
Charlotte, NC 28210-3167

Phone

(980) 236-1511

Fax

(704) 919-5460

NPI assigned

Sep 14, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Jade Integrative Counseling and Wellness, PLLC

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1245879022

  Mental Health

  NPD Authorized official
• Christy Maloney Nutrition LLC

  • Registered Dietitian
  • Charlotte, NC
  • NPI 1508407198
  NPD

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1740658376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5970 FAIRVIEW RD STE 420",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103167",
            "telephone_number": "980-701-4192",
            "fax_number": "980-701-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5970 FAIRVIEW RD STE 420",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103167",
            "telephone_number": "980-236-1511",
            "fax_number": "704-919-5460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2302 Equestrian Dr",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281056775",
            "country_code": "US",
            "telephone_number": "980-236-1511",
            "fax_number": "704-919-5460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHARRYSE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-14",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "11709",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "11709",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "11709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "11709",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cecelia Johnson
• Chanaya R Johnson, RN
• Chanel Johnson
• Chantelle M. Johnson, MA, LPC
• Charnell Johnson, MS,CCC-SLP
• Cheryl Jane Johnson, MA, LMFT
• Chinethia H Johnson
• Christina Danielle Johnson
• Courtney G Johnson, FNP
• Courtney Janae Johnson, LCSWA

• All providers in Charlotte, NC
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.