Provider Demographics
NPI:1417751256
Name:OATES, CONSTANCE JEANETTE (MSW, LCSW-A)
Entity type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:JEANETTE
Last Name:OATES
Suffix:
Gender:
Credentials:MSW, LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2087 OBERRY RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:NC
Mailing Address - Zip Code:28365-7051
Mailing Address - Country:US
Mailing Address - Phone:919-344-5106
Mailing Address - Fax:
Practice Address - Street 1:611 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-5715
Practice Address - Country:US
Practice Address - Phone:919-330-4802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X, 101YM0800X, 106H00000X
NCP0219171041C0700X
NC175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No175T00000XOther Service ProvidersPeer Specialist