Healthcare Provider Details

I. General information

NPI: 1639764640
Provider Name (Legal Business Name): ONE THERAPY AND CONSULTING, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2021
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 PINETREE DR
NEW BERN NC
28562-4430
US

IV. Provider business mailing address

606 PINETREE DR
NEW BERN NC
28562-4430
US

V. Phone/Fax

Practice location:
  • Phone: 252-288-4045
  • Fax: 252-351-0335
Mailing address:
  • Phone: 252-288-4045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENIFER GONZALEZ
Title or Position: OWNER, PRESIDENT
Credential: MSW, LCSW, LCAS, CCS
Phone: 252-288-4045