Provider Demographics
NPI:1881475168
Name:DAVIS, EBONY ROSBOUGH (LCSW-A)
Entity type:Individual
Prefix:
First Name:EBONY
Middle Name:ROSBOUGH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 PINECROFT RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-4705
Mailing Address - Country:US
Mailing Address - Phone:336-935-2970
Mailing Address - Fax:
Practice Address - Street 1:2310 PINECROFT RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-4705
Practice Address - Country:US
Practice Address - Phone:336-935-2970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker