Individual provider · Type 1 NPI

Jasmine Detrice Ellison, LCSW-A

Clinical Social Worker · Goldsboro, NC

NPI number 1003796467 Active

Practice location

1503 Wayne Memorial Dr Ste E
Goldsboro, NC 27534-2203

Call (919) 587-0001 Map

Fax (919) 587-0007

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XP022642 (NC)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1003796467

Jasmine Detrice Ellison, LCSW-A's National Provider Identifier is 1003796467, issued on Sep 5, 2025. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Goldsboro, NC. The record was last updated on Oct 24, 2025.