Provider Demographics
NPI:1417782277
Name:EUBANKS, EBONY S (LSW, MSW, CAMS-II)
Entity type:Individual
Prefix:
First Name:EBONY
Middle Name:S
Last Name:EUBANKS
Suffix:
Gender:F
Credentials:LSW, MSW, CAMS-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2417 WELSH RD STE 223
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2211
Mailing Address - Country:US
Mailing Address - Phone:267-343-5327
Mailing Address - Fax:267-343-8177
Practice Address - Street 1:2417 WELSH RD STE 223
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-2211
Practice Address - Country:US
Practice Address - Phone:267-343-5327
Practice Address - Fax:267-343-8177
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health