The Eb Wellness Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0600395186 Issued in NJ

Legal business name

THE EB WELLNESS CENTER

Practice address

12000 Lincoln Dr W
Suite 405
Marlton, NJ 08053-3402

Phone

(865) 830-1185

Fax

(856) 831-4076

NPI assigned

Feb 18, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ellen Masters, LCSW

Title

Owner

Phone

(856) 830-1185

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361145600000",
    "number": "1114267721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 LINCOLN DR W",
            "address_2": "SUITE 405",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533402",
            "telephone_number": "865-830-1185",
            "fax_number": "856-831-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 LINCOLN DR W",
            "address_2": "SUITE 405",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533402",
            "telephone_number": "865-830-1185",
            "fax_number": "856-831-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EB WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-18",
        "last_updated": "2013-02-18",
        "status": "A",
        "authorized_official_last_name": "MASTERS",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-830-1185",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "0600395186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.