MRS. LATASHA MICHELLE ELLIS (NPI# 1487832671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487832671 |
| Entity Type | Individual |
| Full Name | MRS. LATASHA MICHELLE ELLIS |
| Other Name | MS. LATASHA MICHELLE QUAILES |
| Credential | LCSW |
| Practice Address |
766 Hartness Rd Statesville NC 28677-3425 |
| Mailing Address |
200 E 2nd Ave Gastonia NC 28052-4358 |
| Practice Telephone | 7043803620 |
| Practice Fax Number | 7043803623 |
| Mailing Telephone | 7048741904 |
| Enumeration Date | 2008-02-10 |
| Last Update Date | 2020-02-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
C005951 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6106903 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13420 Reese Blvd W, Huntersville, NC 280787925 | 7049997378 |
| Street Address |
766 HARTNESS RD |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28677-3425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669464160 | Keith A Gatlin | Internal Medicine | 766 Hartness Rd, Statesville, NC 28677-3425 | 2005-08-19 |
| 1912547415 | Gaston Family Health Services, Inc | Clinic/Center | 766 Hartness Rd, Statesville, NC 28677-3425 | 2020-01-13 |
| 1457996274 | Terri Chang Lee | Nurse Practitioner | 766 Hartness Rd, Statesville, NC 28677-3425 | 2019-11-15 |
| 1922195288 | Piedmont Healthcare, Pa | Durable Medical Equipment & Medical Supplies | 766 Hartness Rd, Statesville, NC 28677-3425 | 2006-10-06 |
| 1053355834 | Mona S. Ismail | Psychiatry & Neurology | 766 Hartness Rd, Statesville, NC 28677-3479 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306472311 | Crystal Medley Hopkins | Nurse Practitioner | 105 Summer Breeze Court, Statesville, NC 28677 | 2020-03-21 |
| 1922634484 | Tracey Holton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Easterseals Ucp, 913 Carolina Ave N, Statesville, NC 28677 | 2020-03-17 |
| 1962069286 | Leap Child & Family Services LLC | Developmental Therapist | 119 North Tradd Street, Statesville, NC 28677 | 2019-05-22 |
| 1831604891 | Ingles Markets Inc | Pharmacy | 722 Sullivan Rd, Statesville, NC 28677 | 2017-12-12 |
| 1235663162 | Sandra Lorraine Scalese | Physical Therapy Assistant | 520 Valley Street, Brian Center Health and Rehabilitation, Statesville, NC 28677 | 2017-04-18 |
| 1437698891 | Sherry Blevins Hager | Pharmacist | 722 Sullivan Road, Statesville, NC 28677 | 2017-02-17 |
| 1063828507 | Susan Marie S Sheffield | Dentist | 518 Brookdale Drive, Statesville, NC 28677 | 2014-07-04 |
| 1659782449 | Easter Seals Ucp | Community/Behavioral Health | 913 Carolina Ave, Statesville, NC 28677 | 2014-05-14 |
| 1306268016 | Randall Scott Perry | Dentist | 1132 Davie Avenue, Statesville, NC 28677 | 2014-01-15 |
| 1215215876 | Silhouette Enterprises | Prosthetic/Orthotic Supplier | 909 Carolina Ave, Statesville, NC 28677 | 2011-08-01 |
| Find all providers in zip 28677 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043823396 | Ketwan Kareem Graham | Social Worker | 474 N Center St, Statesville, NC 28677-4022 | 2020-08-26 |
| 1487284493 | Tammy Yanus Tevepaugh | Social Worker | 929 Brookhaven Rd, Statesville, NC 28625-9234 | 2020-01-17 |
| 1396387270 | Laurie B Trosuk | Social Worker | 1602 Davie Ave, Statesville, NC 28677-3520 | 2019-10-12 |
| 1689971590 | Desiree' Benfield Crosswhite | Social Worker | 206 Cooper St Ste 117, Statesville, NC 28677-5897 | 2011-02-13 |
| 1679878003 | John Earle Frazier | Social Worker | 431 Lewis Ferry Rd, Statesville, NC 28677-8707 | 2011-01-15 |
| 1639495088 | Shameka Harley Chambers | Social Worker | 215 Barium Springs Drive, Statesville, NC 28677 | 2010-04-09 |
| 1518293703 | Amy Lynn Davis | Social Worker | 108 Carolinian Dr, Statesville, NC 28677-9800 | 2009-10-23 |
| 1922204692 | Amy Perras Eisele | Social Worker | 229 Davie Ave, Statesville, NC 28677-5316 | 2007-06-21 |
| 1093916751 | Barium Springs Home for Children | Social Worker | 138 Barium Springs Drive, King - Prtf, Statesville, NC 28677 | 2007-05-30 |
| 1053496406 | Brenda K Martin | Social Worker | 127 N Green St, Statesville, NC 28677-5375 | 2006-10-26 |
| Find all providers in STATESVILLE | ||||
| City | STATESVILLE |
| Zip Code | 28677 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.