Active NPI
Ebonie Kittrell, LCSWA
- Clinical Social Worker
- Reidsville, NC
National Provider Identifier
1235851601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P018269
- Practice address
- 229 Turner Dr
Reidsville, NC 27320-5736 - Phone
- (336) 349-2233
- NPI assigned
- Sep 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P018269 | NC | Primary |
Addresses
Primary practice location
229 Turner Dr
Reidsville, NC 27320-5736
Mailing address
308 Victor PL Apt 4L
Greensboro, NC 27406-1779
Phone (336) 458-6868
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P018269 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1235851601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 VICTOR PL APT 4L",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274061779",
"telephone_number": "336-458-6868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 TURNER DR",
"city": "REIDSVILLE",
"state": "NC",
"postal_code": "273205736",
"telephone_number": "336-349-2233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITTRELL",
"first_name": "EBONIE",
"name_prefix": "Ms.",
"credential": "LCSWA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-13",
"last_updated": "2022-09-13",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P018269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reidsville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.