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Contact Information

ETHOS SERVICES
432 E LONG AVE STE 2
GASTONIA, NC28054-2540
 Phone: 980-416-3025
 Fax: 980-448-3419
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
 

Adolescent and Children Mental Health

261QM0855X
 

Adult Mental Health

261QM0850X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Community Health

261QC1500X
 

Developmental Disabilities

261QD1600X
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for ETHOS SERVICES

NPI Number 1639806359
LBN Legal business name ETHOS SERVICES
Authorized official BENNY LOCKLEAR - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/03/2022
Last updated 12/17/2025 - About 6 months ago
Identifiers
NC Medicaid 1467162065
NC Medicaid 1639806359
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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