Ebony Eromobor, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24866 Issued in MN

Practice address

151 Silver Lake Rd NW Unit 209
New Brighton, MN 55112-8108

Phone

(612) 255-7545

NPI assigned

Feb 26, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Village Support Therapy and Consulting LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New Brighton, MN
  • NPI 1356964332
  NPD Authorized official

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1962036145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SILVER LAKE RD NW UNIT 209",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551128108",
            "telephone_number": "612-255-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SILVER LAKE RD NW UNIT 209",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551128108",
            "telephone_number": "612-255-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EROMOBOR",
        "first_name": "EBONY",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-26",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elegant Services L.L.C
• Sadak Elmi
• Enriched Living LLC
• Epic Home Healthcare LLC
• Eric J Hering DC, PA
• Essence Chiropractic & Health PLLC
• Evergreen Care Community LLC
• Extendicare Homes, Inc.
• Tyson Fabyanske, MA, LADC
• Heather Maracle Fahey, PHARM.D

• Clinical Social Worker in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.