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Organization

ETHOS SERVICES

Active
Other names
Tri-Insurance LLC, Ethos Services LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BENNY LOCKLEAR JR. MSW (CEO)
(910) 964-0678
Entity
Organization

Contact information

Practice address
432 E LONG AVE STE 2, GASTONIA, NC 28054-2540
(980) 416-3025
(980) 448-3419
Mailing address
432 E LONG AVE STE 2, GASTONIA, NC 28054-2540
(980) 416-3025
(980) 448-3419

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
207Q00000X
Family Medicine Physician
251S00000X
Community/Behavioral Health Agency
Primary
261QC1500X
Community Health Clinic/Center
261QD1600X
Developmental Disabilities Clinic/Center
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1467162065
NC
05
1639806359
NC
Enumeration date
08/03/2022
Last updated
12/17/2025
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