Individual provider Active NPI

Ellie Lawanna Mobley, M.ED, LPCC-S, LCADC

  • Mental Health Counselor
  • Middlesboro, KY
National Provider Identifier
1205054970
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
105702 Issued in KY
Practice address
504 S 24TH St
Middlesboro, KY 40965-1447
Phone
(606) 248-1540
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 165995 KY
Mental Health Counselor 101YM0800X 105702 KY Primary

Addresses

Primary practice location

504 S 24TH St
Middlesboro, KY 40965-1447

Mailing address

100 S Broadway St
Glasgow, KY 42141-2604

Other identifiers 1

IdentifierTypeStateIssuer
7100291930MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 S Broadway St
Glasgow, KY 42141-2604

PO Box
Suite 1003
Columbia, KY 42728-6003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
165995KYMDAddiction (Substance Use Disorder) Counselor
105702KYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland River Behavioral Health, Inc PastSince Aug 26, 2002 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1205054970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S BROADWAY ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421412604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 S 24TH ST",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651447",
            "telephone_number": "606-248-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "ELLIE",
        "middle_name": "LAWANNA",
        "name_prefix": "Ms.",
        "credential": "M.ED, LPCC-S, LCADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "165995",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "105702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100291930",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlesboro, KY

Sources for this page

Verify at the official NPI Registry.