Provider Demographics
NPI:1255028155
Name:EBERT, GAIL ELLIS (LMFT-A, MMFT)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:ELLIS
Last Name:EBERT
Suffix:
Gender:F
Credentials:LMFT-A, MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CONNECTICUT AVE
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-2043
Mailing Address - Country:US
Mailing Address - Phone:864-381-2097
Mailing Address - Fax:
Practice Address - Street 1:707 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-1281
Practice Address - Country:US
Practice Address - Phone:864-209-1090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist