Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Marina Gordula Johnson, LCSW

Individual provider Clinical Social Worker · NPI 1134568801

Mrs. Marina Gordula Johnson, LCSW is a Clinical Social Worker in Fayetteville, North Carolina. Qualified in 1995, 31 years ago. Practices as a sole proprietor. Licensed in North Carolina.

Years since qualifying
31
Licensed in
NC
In the registry since
2013
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

2005 Hope Mills Rd
Fayetteville, NC 28304-4224
Phone: (910) 920-5802
Fax: (910) 491-3884
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C009623 (NC)

Record details

NPI number1134568801
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJune 17, 2013
Last updated in NPPESApril 14, 2020
Certification dateApril 14, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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