Active NPI
Ulises Gonzalez, LPC
- Professional Counselor
- Buckeye, AZ
National Provider Identifier
1033319157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 14052
- Practice address
- 1300 N Miller Rd
Buckeye, AZ 85326-1000 - Phone
- (623) 628-8788
- Fax
- (623) 466-6127
- NPI assigned
- Jul 18, 2007
- Last updated
- Jan 22, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 14052 | AZ | Primary |
| Marriage & Family Therapist | 106H00000X | 10260 | AZ |
Addresses
Primary practice location
1300 N Miller Rd
Buckeye, AZ 85326-1000
Mailing address
PO Box 1291
Buckeye, AZ 85326-0095
Phone (623) 628-8788
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14052 | Other | AZ | LPC |
| 10260 | Other | AZ | LAMFT |
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 |
|---|---|---|---|
| 14052 | AZ | MD | Professional Counselor |
| 10260 | AZ | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Light of Life Counseling Services LLC | Professional | Current | Accepting new patients |
| Pathbuilders Counseling Services, Inc | Marriage & Family Therapist | Past | Accepting new patients |
Locations
6500 S Miller Rd
Buckeye, AZ 85326
Phone (480) 261-0105
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Buckeye, AZ
- NPI 1861931826
Professional
-
- Marriage & Family Therapist
- Buckeye, AZ
- NPI 1790269256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453420800000",
"number": "1033319157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1291",
"city": "BUCKEYE",
"state": "AZ",
"postal_code": "853260095",
"telephone_number": "623-628-8788",
"fax_number": "623-466-6127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 N MILLER RD",
"city": "BUCKEYE",
"state": "AZ",
"postal_code": "853261000",
"telephone_number": "623-628-8788",
"fax_number": "623-466-6127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "ULISES",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-18",
"last_updated": "2016-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "14052",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "AZ",
"license": "10260",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC",
"identifier": "14052",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LAMFT",
"identifier": "10260",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Buckeye, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.