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General NPI Number Information
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NPI Number | 1417751256
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Entity Type | Individual
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Provider Name | CONSTANCE JEANETTE OATES MSW, LCSW-A
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Gender | Female
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 611 S GEORGE ST
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City | GOLDSBORO
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State | NC
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Zip | 27530-5715
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Country | US
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Telephone | 919-330-4802
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Fax |
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Provider Business Mailing Address
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Address Line | 2087 OBERRY RD
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City | MOUNT OLIVE
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State | NC
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Zip | 28365-7051
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Country | US
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Telephone | 919-344-5106
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P021917
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | NC
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