Jaclyn Gonzales, LPC-I

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

79320 Issued in TX

Practice address

9500 Tioga Dr
San Antonio, TX 78230-3118

Phone

(210) 616-0828

Fax

(855) 616-0829

NPI assigned

Apr 4, 2018

Last updated

Apr 4, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nueva Vida Behavioral Health Associates,Inc

  • Professional Counselor
  • San Antonio, TX
  • NPI 1669565529
  Medicare reassignment NPD
• Alamo Area Family & Geriatric Medicine Associates, PA

  • Family Medicine Physician
  • Windcrest, TX
  • NPI 1366575706
  NPD (past)

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1023514270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 TIOGA DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303118",
            "telephone_number": "210-616-0828",
            "fax_number": "855-616-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 TIOGA DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303118",
            "telephone_number": "210-616-0828",
            "fax_number": "855-616-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JACLYN",
        "credential": "LPC-I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geoffrey M Gonzales, PMHNP
• Gilbert Gonzales Jr., D.C.
• Guadalupe Carlos Gonzales Jr., L.AC.
• Helen C Gonzales
• Henry Gonzales
• Janice S Gonzales, LBSW
• Jared Gonzales, BCBA
• Jasmine Gonzales
• Jennifer Lauren Gonzales, AGNP-C
• Jennifer M Gonzales, D.O.

• Professional Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.