Edem Matthias Excellence, MS, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P015897 Issued in NC

Practice address

432 East Long Avenue
Suite 2
Gastonia, NC 28054-2540

Phone

(980) 416-3025

Fax

(980) 448-3419

NPI assigned

Mar 9, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Ethos Services

  • Community/Behavioral Health Agency
  • Gastonia, NC
  • NPI 1639806359

  Clinical

  NPD

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1225623499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11125 HAZEL GARDENS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787942",
            "telephone_number": "980-416-3025",
            "fax_number": "980-448-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 EAST LONG AVENUE",
            "address_2": "SUITE 2",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542540",
            "telephone_number": "980-416-3025",
            "fax_number": "980-448-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EXCELLENCE",
        "first_name": "EDEM",
        "middle_name": "MATTHIAS",
        "name_prefix": "Mr.",
        "credential": "MS, LCSW-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-09",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P015897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney M Everett
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• Eyemart Express LLC
• Eyes Wyde Shut Inc.
• Augustine R Eze, MD
• Cynthia Chinemerem Ezedike, MD
• Anna Faidas, MD

• Clinical Social Worker in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.