1598147142 NPI number — ELIZABETH ASHLEY EASON MSW, LCSW, TFCBT

Table of content: ELIZABETH ASHLEY EASON MSW, LCSW, TFCBT (NPI 1598147142)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598147142 NPI number — ELIZABETH ASHLEY EASON MSW, LCSW, TFCBT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EASON
Provider First Name:
ELIZABETH
Provider Middle Name:
ASHLEY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW, LCSW, TFCBT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUNT
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
ASHLEY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598147142
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4736 PRESTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAXTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28364-7738
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-751-1815
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 E 5TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUMBERTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28358-6104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-738-3571
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/19/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C010243 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)