Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jasmine Detrice Ellison, LCSW-A

Individual provider Clinical Social Worker · NPI 1003796467

Jasmine Detrice Ellison, LCSW-A is a Clinical Social Worker in Goldsboro, North Carolina. Practices as a sole proprietor. Licensed in North Carolina.

Licensed in
NC
In the registry since
2025

Practice location Address checks out

1503 Wayne Memorial Dr Ste E
Goldsboro, NC 27534-2203
Phone: (919) 587-0001
Fax: (919) 587-0007
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence P022642 (NC)

Record details

NPI number1003796467
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW-A
Sole proprietorYes
NPI enumeratedSeptember 5, 2025
Last updated in NPPESOctober 24, 2025
Certification dateSeptember 5, 2025

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