Individual provider Active NPI

Jenny Debnam Gonzalez

  • Clinical Social Worker
  • Hope Mills, NC
National Provider Identifier
1063959641
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C012321 Issued in NC
Practice address
5806 Kessinger CT
Hope Mills, NC 28348-9387
Phone
(910) 229-5698
NPI assigned
Jan 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C012321 NC Primary

Addresses

Primary practice location

5806 Kessinger CT
Hope Mills, NC 28348-9387

Mailing address

3484 County Line Rd
Fayetteville, NC 28306-9576
Phone (910) 229-5698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C012321NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1063959641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3484 COUNTY LINE RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283069576",
            "telephone_number": "910-229-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5806 KESSINGER CT",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283489387",
            "telephone_number": "910-229-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JENNY",
        "middle_name": "DEBNAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-20",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hope Mills, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.