MR. JACK L ELLERBE MSW LCAS NPI 1073185245

NPI Information

  • NPI: 1073185245
  • Provider Name: MR. JACK L ELLERBE, MSW, LCAS
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 665 TIMBER TRL
    GOLD HILL, NC
    ZIP 28071
  • Phone: (704) 279-1199

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NPI Details

MR. Jack L Ellerbe, MSW, LCAS is an addiction (substance use disorder) counselor in Gold Hill, NC. MR. Jack L Ellerbe, MSW, LCAS NPI is 1073185245. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

665 TIMBER TRL
GOLD HILL, NC
ZIP 28071-500
Phone: (704) 279-1199
Fax: (704) 279-7668

The enumeration date for this NPI number is 7/15/2021 and was last updated on 2/9/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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