NPIMap

Organization Active NPI

Ethos Services

  • Community/Behavioral Health Agency
  • Gastonia, NC
National Provider Identifier
1639806359
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ETHOS SERVICES
Practice address
432 E Long Ave Ste 2
Gastonia, NC 28054-2540
Phone
(980) 416-3025
Fax
(980) 448-3419
NPI assigned
Aug 3, 2022
Last updated
Dec 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Authorized official

Name
Mr. Benny Locklear Jr., MSWNPI 1467162065
Title
Ceo
Phone
(910) 964-0678

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU
Developmental Disabilities Clinic/Center 261QD1600X NU
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Clinical Social Worker 1041C0700X NU
Family Medicine Physician 207Q00000X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

432 E Long Ave Ste 2
Gastonia, NC 28054-2540

Mailing address

432 E Long Ave Ste 2
Gastonia, NC 28054-2540
Phone (980) 416-3025

Other identifiers 2

IdentifierTypeStateIssuer
1467162065MedicaidNC
1639806359MedicaidNC

Other names 2

  • Tri-Insurance LLC Former legal business name
  • Ethos Services LLC Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL cARE360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240729000480 NC Part B Supplier - Clinic/Group Practice 3274079082 Receives reassigned benefits from 3 practitioners
Practice locations: Gastonia, NC; Stanley, NC

National Provider Directory

National Provider Directory

Locations

432 E Long Ave
Ste 2
Gastonia, NC 28054
Phone (980) 416-3025

106 W Dallas Rd
Stanley, NC 28164
Phone (910) 690-8033

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1639806359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 E LONG AVE STE 2",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542540",
            "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 E LONG AVE STE 2",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542540",
            "telephone_number": "980-416-3025",
            "fax_number": "980-448-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHOS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-03",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "LOCKLEAR",
        "authorized_official_first_name": "BENNY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-964-0678",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467162065",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639806359",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "cARE360",
            "affiliation": "N",
            "address_1": "503 Park St",
            "city": "Belmont",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280123223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Tri-Insurance LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Tri-Insurance LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Ethos Services LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.