Active NPI
Malcolm Campbell Johnson Jr., LCSW, LCAS, CCS
- Addiction (Substance Use Disorder) Counselor
- Concord, NC
National Provider Identifier
1790806727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 835
- Practice address
- 1580 Dartmoor Ave NW
Concord, NC 28027 - Phone
- (704) 425-8782
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 835 | NC | Primary |
| Clinical Social Worker | 1041C0700X | C003566 | NC |
Addresses
Primary practice location
1580 Dartmoor Ave NW
Concord, NC 28027
Mailing address
1580 Dartmoor Ave NW
Concord, NC 28027
Phone (704) 425-8782
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C003566 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1790806727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1580 DARTMOOR AVE NW",
"city": "CONCORD",
"state": "NC",
"postal_code": "28027",
"telephone_number": "704-425-8782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1580 DARTMOOR AVE NW",
"city": "CONCORD",
"state": "NC",
"postal_code": "28027",
"telephone_number": "704-425-8782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MALCOLM",
"middle_name": "CAMPBELL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LCSW, LCAS, CCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "835",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C003566",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.