Provider Demographics
NPI:1548156458
Name:ELLSWORTH, GRACE CAMDEN (MSW, LCSW-A JULY)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:CAMDEN
Last Name:ELLSWORTH
Suffix:
Gender:F
Credentials:MSW, LCSW-A JULY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FEATHERDOWN WAY UNIT 105100
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-0517
Mailing Address - Country:US
Mailing Address - Phone:678-478-2436
Mailing Address - Fax:678-478-2436
Practice Address - Street 1:55 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-3701
Practice Address - Country:US
Practice Address - Phone:828-507-1421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPENDING-JULY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical