Sandy Michelle Johnson, M.S. LPC, NCC, CCTP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6595 Issued in SC

Practice address

1293 Professional Dr Ste a-101
Myrtle Beach, SC 29577-5754

Phone

(843) 605-0514

Fax

(843) 962-5570

NPI assigned

Jun 6, 2014

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Lifecare Counseling LLC

  • Professional Counselor
  • Myrtle Beach, SC
  • NPI 1235803883

  Mental Health

  NPD (past) Authorized official
• Coastal Haven Counseling LLC

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1609314293
  NPD (past)

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655510400000",
    "number": "1982017059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1293 PROFESSIONAL DR STE A101",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775754",
            "telephone_number": "843-213-1307",
            "fax_number": "843-962-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1293 PROFESSIONAL DR STE A-101",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775754",
            "telephone_number": "843-605-0514",
            "fax_number": "843-962-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SANDY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "M.S. LPC, NCC, CCTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-06",
        "last_updated": "2022-06-18",
        "certification_date": "2022-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "6595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC-1874",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaliyah Shanice Johnson, NA
• Kelli Johnson
• Lindsay Marie Johnson, PA
• Michael Allan Johnson, DDS
• Nancy Lauren Johnson, FNP
• Tabitha Ann Johnson, LPN
• Trevor Scott Johnson
• Danielle Renee Johnston, LPC
• Joint Effort Counseling Services, LLC
• Carolyn Rae Jones, FNP-C

• Mental Health Counselor in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2022; 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.