Jessica Melissa Gonzalez, RMHCI, RMFTI

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMT4153 Issued in FL

Practice address

21 Columbia St Ste 201
Orlando, FL 32806-1133

Phone

(321) 841-0746

NPI assigned

Sep 6, 2024

Last updated

Sep 6, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Neurogenesis Center of Florida, PLLC

  dba Amber Fasula, Psy.D.

  • Clinical Psychologist
  • Maitland, FL
  • NPI 1922474907
  NPD (past)

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

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1154156305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13104 AUBREY LN",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876536",
            "telephone_number": "407-504-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 COLUMBIA ST STE 201",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061133",
            "telephone_number": "321-841-0746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "253 N Orlando Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Maitland",
            "state": "FL",
            "postal_code": "327515521",
            "country_code": "US",
            "telephone_number": "407-790-4101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JESSICA",
        "middle_name": "MELISSA",
        "credential": "RMHCI, RMFTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH25889",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "IMT4153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jalines Gonzalez, BT
• Javier Gonzalez, D.O.
• Javier Ignacio Gonzalez, M.D.
• Jaymel Gonzalez Sr., BSW
• Jazyha Faith Gonzalez, RBT
• Juan Carlos Gonzalez
• Juan Jose Gonzalez, M.D.
• Katherine Gonzalez, RN
• Kevin Gonzalez
• Krystal Gonzalez, MA, CCC-SLP

• Marriage & Family Therapist in Orlando, FL
• Providers in Orlando, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.