Individual provider Active NPI

Ebony Hall, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1427558519
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12572-C Issued in NV
Practice address
4221 McLeod Dr
Las Vegas, NV 89121-5215
Phone
(702) 474-6450
NPI assigned
Feb 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12572-C NV Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 07512-I NV
Behavior Analyst 103K00000X
Clinical Social Worker 1041C0700X IC-2264 NV

Addresses

Primary practice location

4221 McLeod Dr
Las Vegas, NV 89121-5215

Mailing address

4221 McLeod Dr
Las Vegas, NV 89121-5215
Phone (702) 474-6450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231013000493 NV Practitioner - Clinical Social Worker 3375998107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridge Counseling Associates IncGroup PAC ID 4486914975, 16 clinicians

Practice addresses (Care Compare)

4221 McLeod Dr
Las Vegas, NV 89121-5215
Phone (702) 474-6450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07512-INVMDAddiction (Substance Use Disorder) Counselor
12572-CNVMDClinical Social Worker
IC-2264NVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bridge Counseling Associates, Inc CurrentSince Dec 6, 2025 Accepting new patients

Locations

1640 Alta Dr
Ste 4
Las Vegas, NV 89106
Phone (702) 474-6450

4221 McLeod Dr
Las Vegas, NV 89121
Phone (702) 474-6450

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f9a6475a-3dbd-47b2-979a-55064cfdbd51/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1427558519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 MCLEOD DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215215",
            "telephone_number": "702-474-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 MCLEOD DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215215",
            "telephone_number": "702-474-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "EBONY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-15",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "12572-C",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "07512-I",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "IC-2264",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.