Individual provider Active NPI

Larry Brent Eubanks, LCSW

  • Clinical Social Worker
  • Ft. Rucker, AL
National Provider Identifier
1922437201
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3540C Issued in AL
Practice address
301 Andrews Ave.
Ft. Rucker, AL 36362
Phone
(334) 255-7523
NPI assigned
Nov 6, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3540C AL Primary

Addresses

Primary practice location

301 Andrews Ave.
Ft. Rucker, AL 36362

Mailing address

301 Andrews Ave.
Ft. Rucker, AL 36362
Phone (334) 255-7523

Other identifiers 1

IdentifierTypeStateIssuer
3540COtherALLICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3540CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wiregrass Behavioral Group LLC Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1118 Ross Clark Cir
Ste 500
Dothan, AL 36301
Phone (334) 794-4159

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1922437201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ANDREWS AVE.",
            "city": "FT. RUCKER",
            "state": "AL",
            "postal_code": "36362",
            "telephone_number": "334-255-7523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ANDREWS AVE.",
            "city": "FT. RUCKER",
            "state": "AL",
            "postal_code": "36362",
            "telephone_number": "334-255-7523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "LARRY",
        "middle_name": "BRENT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-06",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "3540C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "3540C",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft. Rucker, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.