Ea Clinical Multiservices, PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EA CLINICAL MULTISERVICES, PLLC

Practice address

401 Hawthorne LN Ste 110-115
Charlotte, NC 28204-2484

Phone

(704) 396-3292

NPI assigned

Nov 14, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Elba I. Acosta, LCSW-LCASNPI 1114194354

Title

Ceo

Phone

(718) 644-3542

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elba Iris Acosta, LCSW

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1114194354
  NPD Authorized official

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1871201228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HAWTHORNE LN STE 110-115",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042484",
            "telephone_number": "704-396-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HAWTHORNE LN STE 110-115",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042484",
            "telephone_number": "704-396-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EA CLINICAL MULTISERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "ELBA",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-644-3542",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW-LCAS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176080",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW1464",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Nov 14, 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.