Provider Demographics
NPI:1912181918
Name:JOHNSON, JAMES GREY (MA, LCAS, LCMHC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GREY
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MA, LCAS, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:NC
Mailing Address - Zip Code:28630-1850
Mailing Address - Country:US
Mailing Address - Phone:828-430-1537
Mailing Address - Fax:
Practice Address - Street 1:63 DUKE ST
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-1850
Practice Address - Country:US
Practice Address - Phone:828-430-1537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
NC15033101YP2500X
NCLCAS-20930101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional