NPIMap

Cielo Gonzalez, QMHA, CNA, YSS, PSW

Individual provider Active NPI Case Manager/Care Coordinator · Lakeview, OR

NPI 1134814585 · NPPES record last updated Nov 12, 2024

Key facts

NPI
1134814585
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
License
23-QMHA-R-3641 (OR)
Practice address
35 S G St
Lakeview, OR 97630-1817
Phone
(541) 947-6021
Fax
(541) 219-8114
NPI assigned
Apr 10, 2023
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
23-QMHA-R-3641ORMDCase Manager/Care Coordinator
4D7E1C67-F2E8-4471-8ORMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Health District Current
since Apr 16, 2023		 Accepting new patients

Locations

35 S G St
Lakeview, OR 97630

100 N D St
Ste 100
Lakeview, OR 97630
Phone (541) 947-6045

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 4D7E1C67-F2E8-4471-8 OR
Case Manager/Care Coordinator 171M00000X 23-QMHA-R-3641 OR Yes

Addresses

Primary practice location

35 S G St
Lakeview, OR 97630-1817

Mailing address

35 S G St
Lakeview, OR 97630-1817
Phone (541) 947-6021

Other providers in Lakeview, OR

All providers in Lakeview, OR · Case Manager/Care Coordinator in Oregon

Sources for this page

Verify at the official NPI Registry.