Ebony White, LCMHC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A14736 Issued in NC

Practice address

10130 Mallard Creek Rd Ste 300
Charlotte, NC 28262-6001

Phone

(980) 430-9943

NPI assigned

Mar 21, 2019

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

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 and National Provider Directory roles.

• Hidden Well Therapy Solutions

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1194523779
  NPD Authorized official
• Healing and Hope Counseling Center, PLLC

  • Professional Counselor
  • Gastonia, NC
  • NPI 1275848517
  NPD (past)
• Preferred Choice Healthcare

  • Community/Behavioral Health Agency
  • Shelby, NC
  • NPI 1073827861

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1235699752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 LEECREST DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282142577",
            "telephone_number": "980-430-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10130 MALLARD CREEK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282626001",
            "telephone_number": "980-430-9943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1243 E Dixon Blvd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "NC",
            "postal_code": "281526893",
            "country_code": "US",
            "telephone_number": "704-487-4000 x1018",
            "fax_number": "704-487-4005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "419 S York St",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280524035",
            "country_code": "US",
            "telephone_number": "704-865-8722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "EBONY",
        "name_prefix": "Ms.",
        "credential": "LCMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-21",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A14736",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A14736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.fullscopecounseling.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "10130 Mallard Creek Rd Ste 300",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282626001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chesney White, CRNA
• Cheyenne White
• Clare L. White, CRNA
• Danielle White
• De'Asija M White
• Elizabeth White
• Elizabeth De la Cruz White
• Emily Ruth White, MD
• Erica N White, BA, CPSS
• Janelle Renee White, MD

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.