Active NPI
Jerome Robert Ebacher, LCSW
- Clinical Social Worker
- Lehigh Acres, FL
National Provider Identifier
1952773640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW10037
- Practice address
- 826 Grenada Ave
Lehigh Acres, FL 33974 - Phone
- (218) 391-5158
- NPI assigned
- Oct 21, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | SW10037 | FL | |
| Clinical Social Worker | 1041C0700X | SW10037 | FL | Primary |
Addresses
Primary practice location
826 Grenada Ave
Lehigh Acres, FL 33974
Mailing address
826 Grenada Ave
Lehigh Acres, FL 33974
Phone (218) 391-5158
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrative Treatment Options | Past | Accepting new patients |
Organizations & group practices 1
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": "1445385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445385600000",
"number": "1952773640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "826 GRENADA AVE",
"city": "LEHIGH ACRES",
"state": "FL",
"postal_code": "33974",
"telephone_number": "218-391-5158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "826 GRENADA AVE",
"city": "LEHIGH ACRES",
"state": "FL",
"postal_code": "33974",
"telephone_number": "218-391-5158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBACHER",
"first_name": "JEROME",
"middle_name": "ROBERT",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-10-21",
"last_updated": "2015-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "SW10037",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW10037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lehigh Acres, FL
- Dwic of Tampa Bay, Inc (MedExpress Urgent Care - Lehigh Acres, Homestead Rd N)
- Anita Dzelilovic, LCSW
- E& M Medical Billing Services (E& m medical services)
- East Lee County Rebabilitation Center Inc
- Julianne Eastmond
- Herminia Echenique, RBT
- Yilena Echerri Siverio, BCABA
- Yuslamis Echevarria Ramos
- Flavia Echevarria Salazar
- Arianna Echevarria
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.