Organization
EA CLINICAL MULTISERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELBA I. ACOSTA LCSW-LCAS (CEO)
(718) 644-3542
Entity
Organization
Contact information
Practice address
401 HAWTHORNE LN STE 110-115, CHARLOTTE, NC 28204-2484
(704) 396-3292
Mailing address
401 HAWTHORNE LN STE 110-115, CHARLOTTE, NC 28204-2484
(704) 396-3292
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176080
—
NC
05
—
SW1464
—
SC
Enumeration date
11/14/2022
Last updated
11/14/2022
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