Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Shanta Johnson, LCSW

Individual provider Clinical Social Worker · NPI 1023569613

Mrs. Shanta Johnson, LCSW is a Clinical Social Worker in Creedmoor, North Carolina. Qualified in 2019, 7 years ago. Practices with Sondermind Provider Network LLC, a 1,258-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts and North Carolina.

Years since qualifying
7
Licensed in
MA, NC
In the registry since
2016
Specialties on file
2
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

1195 Shining Water Ln
Creedmoor, NC 27522-7243
Phone: (984) 209-0303
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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 C008341 (NC)
Clinical Social Worker Taxonomy 1041C0700X · Licence LICSW125798 (MA)

Record details

NPI number1023569613
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedOctober 18, 2016
Last updated in NPPESJune 16, 2025
Certification dateJune 16, 2025
Mailing addressPo Box 903, Creedmoor, NC 27522-0903

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Sondermind Provider Network Llc — 1258 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Creedmoor