Healthcare Provider Details

I. General information

NPI: 1174458251
Provider Name (Legal Business Name): CASSANDRA JOHNSON-HOLT LCMHC SUPERVISOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 GREEN VALLEY RD
GREENSBORO NC
27408-7018
US

IV. Provider business mailing address

2195 MCLAUGHLIN DR
GREENSBORO NC
27406-8578
US

V. Phone/Fax

Practice location:
  • Phone: 336-370-8100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number1274861
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: