Individual
JHANE' HADIYA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
1903 N HARRISON AVE STE 200, CARY, NC 27513-3093
(919) 218-4211
(877) 292-0656
Mailing address
200 GREAT RIDGE CT, MORRISVILLE, NC 27560-6788
(919) 218-4211
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
104100000X
Social Worker
0906009697
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0734001439
TRAINEE MENTAL HEALTH PROFESSIONAL
VA
01
—
0906009697
SUPERVISEE LICENSE
VA
01
—
LCAS26321
NC STATE LICENSE
NC
Enumeration date
11/06/2020
Last updated
11/10/2020
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