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Individual

MRS. SHARON P JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCAS, LCSW

Contact information

Practice address
4401 PROVIDENCE LN, WINSTON SALEM, NC 27106-3226
(336) 896-1323
(336) 896-1327
Mailing address
4401 PROVIDENCE LN, WINSTON SALEM, NC 27106-3226
(336) 896-1323
(336) 896-1327

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16481
NC
101YP2500X
Professional Counselor
16481
NC
104100000X
Social Worker
Primary
CO12183
NC
1041C0700X
Clinical Social Worker
PO11307
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16481
NC SUBSTANCE ABUSE PROFESIONAL PRACTICE BOARD
NC
01
CO12183
NORTH CAROLINA SOCIAL WORK CERTIFICATION AND LICENSURE BOARD
NC
01
PO11307
NORTH CAROLINA SOCIAL WORK CERTIFICATION AND LICENSURE BOARD
NC
Enumeration date
03/30/2009
Last updated
05/02/2019
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