Eboni R. Mormant, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

006759 Issued in GA

Practice address

500 Sun Valley Dr Ste D2
Roswell, GA 30076-5636

Phone

(770) 910-9162

Fax

(770) 910-9768

NPI assigned

Feb 7, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Eboni R. Henry Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Expansion Counseling Services, LLC

  • Professional Counselor
  • Roswell, GA
  • NPI 1720539562
  NPD Authorized official
• Groundbreaking Guidance Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roswell, GA
  • NPI 1194330449
  NPD

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1184963357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SUN VALLEY DR STE D2",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765636",
            "telephone_number": "770-910-9162",
            "fax_number": "770-910-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SUN VALLEY DR STE D2",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765636",
            "telephone_number": "770-910-9162",
            "fax_number": "770-910-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORMANT",
        "first_name": "EBONI",
        "middle_name": "R.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-07",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DE",
            "license": "PC-0011103",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401016779",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "006759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Roswell",
            "affiliation": "N",
            "address_1": "500 Sun Valley Dr Ste G3",
            "city": "Roswell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300765639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EBONI",
            "last_name": "HENRY",
            "middle_name": "R.",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicole Yvette Moore, FNP-C
• Kiara Mora-Ramirez
• Nathan Mordel, MD
• Belton Anthony Morgan Jr., MT-BC
• Ryan Morissaint
• Phaion D Mormant
• Audrey Morris
• Matthew Christopher Morris, DNP, MS, RN, NEA-BC
• Mtizi Dee Morris, D.M.D.
• Jennifer M Morrison, PA-C

• Professional Counselor in Roswell, GA
• Providers in Roswell, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.