Jerome L Ellis is a Clinical in Goldsboro, North Carolina. Jerome L Ellis practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jerome L Ellis is 1023008638. The last update date is 2009-01-22.
Jerome L Ellis's current location address is 1050 Jabarrah Ave, Goldsboro, North Carolina. You can contact this provider via phone number 9197220928 and fax number 9197221952. The mailing address for Jerome L Ellis is 1050 Jabarrah Ave, Goldsboro, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jerome L Ellis |
|---|---|
| Address | 1050 Jabarrah Ave, Goldsboro, North Carolina |
| Phone Number | 9197220928 |
| Fax Number | 9197221952 |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1023008638 |
|---|---|
| Provider Enumeration Date | 2005-10-25 |
| Last Updated Date | 2009-01-22 |
Provider Mailing Address Detail
| Address | 1050 Jabarrah Ave |
|---|---|
| City | Goldsboro |
| State | North Carolina (NC) |
| Post Code | 275312310 |
| Phone Number | 9197220928 |
| Fax Number | 9197221952 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | C004119 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique identification code assigned to Jerome L Ellis by the Centers for Medicare & Medicaid Services?
The Jerome L Ellis has been issued the NPI (National Provider Identifier) 1023008638. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Jerome L Ellis is located?
The Jerome L Ellis is situated at the following address: 1050 Jabarrah Ave, Goldsboro, NC, 275312310.
What is the area of specialization for Jerome L Ellis, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Jerome L Ellis is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 1041C0700X.
On what date did the Jerome L Ellis receive its 1023008638 assignment from the Centers for Medicare & Medicaid Services?
The Jerome L Ellis was assigned its 1023008638 by the Centers for Medicare & Medicaid Services on 2005-10-25.
When was the information regarding Jerome L Ellis most recently updated?
The details pertaining to the Jerome L Ellis, including its address, specialty, and other relevant information, were last refreshed on 2009-01-22.
NPI Number: 1063415297
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