Timisha Mercedes Johnson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P017545 Issued in NC

Practice address

1030 N Rogers LN Ste 121
Raleigh, NC 27610-6083

Phone

(910) 336-2293

NPI assigned

May 21, 2022

Sex

Female

Sole proprietor

Yes

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.

• Healed and Educated

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1255010187
  NPD Authorized official

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

{
    "created_epoch": "1653091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1942948807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 N ROGERS LN STE 121",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276106083",
            "telephone_number": "910-336-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 N ROGERS LN STE 121",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276106083",
            "telephone_number": "910-336-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TIMISHA",
        "middle_name": "MERCEDES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-21",
        "last_updated": "2023-10-13",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P017545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Johnson
• Sherry Tang Johnson, M.D.
• Sonia Lynee Johnson
• Taij Mallory Johnson, LPCA
• Teilexis Rajene' Brichel Johnson
• Traci Yvette Johnson, LCMHC-A
• Tykeena Lee Johnson
• Valencia Meshay Johnson
• Victoria N Johnson, CD(DONA)
• Whitney Brooke Johnson, LPC

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, 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 Oct 13, 2023; 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.