Individual provider Active NPI

Alan Gonzalez

  • Mental Health Counselor
  • Bronx, NY
National Provider Identifier
1104633064
Registry record updated Dec 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
015467 Issued in NY
Practice address
445 Gerard Ave Apt 621
Bronx, NY 10451-2382
Phone
(347) 376-0576
NPI assigned
Dec 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 015467 NY Primary

Addresses

Primary practice location

445 Gerard Ave Apt 621
Bronx, NY 10451-2382

Mailing address

445 Gerard Ave Apt 621
Bronx, NY 10451-2382
Phone (347) 376-0576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20250204001712 NY Practitioner - Mental Health Counselor 4880124049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Talkspace Medical Services Ny PCGroup PAC ID 0143671966, 44 clinicians

Practice addresses (Care Compare)

9 Railside Ave
FL 10
White Plains, NY 10605-3408
Phone (212) 284-7206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Talkspace Medical Services Ny PC CurrentSince Jan 1, 2025 Accepting new patients

Locations

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1734134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734134400000",
    "number": "1104633064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 GERARD AVE APT 621",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104512382",
            "telephone_number": "347-376-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 GERARD AVE APT 621",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104512382",
            "telephone_number": "347-376-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ALAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-14",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "015467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.