OrganizationActive
Innovative Lifestyle Network, LLC
NPI 1437709482 · Community/Behavioral Health Agency · Charlotte, NC
Provider details
- NPI number
- 1437709482
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Shanika Johnson, Owner/Therapist(704) 421-1330
Specialties & taxonomies
Agencies
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
301 Mccullough Dr Ste 400
Charlotte, NC 28262-1336
Phone: (704) 504-7274
Fax: (704) 919-5564
Street-level locationGet directions
Mailing address
301 Mccullough Dr Ste 400
Charlotte, NC 28262-1336
Registry dates
- Enumerated
- 2019-09-11
- Last updated
- 2022-07-28
- Certified
- 2022-07-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.