Provider Demographics
NPI:1598191546
Name:EBBE, CHRISTIAN E (MSW, LCSW-A, LCAS-A)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:E
Last Name:EBBE
Suffix:
Gender:M
Credentials:MSW, LCSW-A, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 PINCKNEY ST
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-2220
Mailing Address - Country:US
Mailing Address - Phone:910-641-0600
Mailing Address - Fax:910-641-4178
Practice Address - Street 1:1911 S 17TH ST STE 100
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6663
Practice Address - Country:US
Practice Address - Phone:910-791-9625
Practice Address - Fax:910-792-9799
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0069401041C0700X
NC3507-A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical