Marisa Katherine Gonzales, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

15736 Issued in AZ

Practice address

3610 N 44TH St
Phoenix, AZ 85018-6059

Phone

(602) 638-6661

NPI assigned

Dec 19, 2016

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2343/brand/1/csg/1/fhir/r4

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.

• Fusion Care Group, a Psychological Professional Corporation

  • Clinical Psychologist
  • Alpine, CA
  • NPI 1275177982
  NPD (past)

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1053856500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 W THUNDERBIRD RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850236248",
            "telephone_number": "602-638-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 N 44TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850186059",
            "telephone_number": "602-638-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "MARISA",
        "middle_name": "KATHERINE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-19",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "15736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faith Marie Gonzales
• Jenna Lee Gonzales, AGACNP
• Jessica Danielle Gonzales, M.ED, BCBA, LBA
• Julia Gonzales, RBT
• Karlene Marie Gonzales, PA-C
• Martin Gonzales
• Miguel Roberto Gonzales, M.D.
• Monica Marcella Gonzales, COTA
• Savanah R. Gonzales
• Shirley Rhea Gonzales

• Professional Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.

Verify at the official NPI Registry.