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General NPI Number Information
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NPI Number | 1932068996
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Entity Type | Individual
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Provider Name | GWENDOLYN JUANITA BASS JONES LCMHCA
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Gender | Female
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 1015 CONFERENCE DR
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City | GREENVILLE
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State | NC
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Zip | 27858-5969
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Country | US
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Telephone | 252-695-0269
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Fax |
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Provider Business Mailing Address
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Address Line | 2595 WESTMINSTER DR
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City | WINTERVILLE
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State | NC
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Zip | 28590-8954
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Country | US
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Telephone | 919-673-6460
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A22460
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License Number State | NC
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