Active NPI
Aanya Lynne Gonzalez
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1003540485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- A14062
- Practice address
- 4425 NE Broadway
Portland, OR 97213-1425 - Phone
- (503) 258-4555
- NPI assigned
- Jul 12, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | A14062 | OR | Primary |
Addresses
Primary practice location
4425 NE Broadway
Portland, OR 97213-1425
Mailing address
4425 NE Broadway
Portland, OR 97213-1425
Phone (503) 258-4555
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
| License | State | Type | Specialty |
|---|---|---|---|
| A14062 | OR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youth Villages | Past | Accepting new patients | |
| Youth Villages | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Lake Oswego, OR
- NPI 1740729490
-
- Adolescent and Children Mental Health Clinic/Center
- Lake Oswego, OR
- NPI 1992243992
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747699200000",
"number": "1003540485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4425 NE BROADWAY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972131425",
"telephone_number": "503-258-4555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4425 NE BROADWAY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972131425",
"telephone_number": "503-258-4555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "AANYA",
"middle_name": "LYNNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-12",
"last_updated": "2025-05-20",
"certification_date": "2025-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "A14062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.