Healthcare Provider Details

I. General information

NPI: 1871008672
Provider Name (Legal Business Name): ACHIEVING CHANGES COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2554 LEWISVILLE CLEMMONS RD STE 112
CLEMMONS NC
27012-9927
US

IV. Provider business mailing address

PO BOX 1417
CLEMMONS NC
27012-1417
US

V. Phone/Fax

Practice location:
  • Phone: 980-226-0414
  • Fax: 336-776-0091
Mailing address:
  • Phone: 336-283-2510
  • Fax: 336-776-0091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1871008672
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: MELISSA ANN JOHNSON
Title or Position: OWNER
Credential: MSW, LCSW
Phone: 336-283-2510