Active NPI
Shantel Nikole Gonsalves, LPC
- Counselor
- Austin, TX
National Provider Identifier
1164096277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 75430
- Practice address
- 6709 Denia Dr
Austin, TX 78739-1615 - Phone
- (512) 783-8625
- NPI assigned
- May 14, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 75430 | TX | Primary |
Addresses
Primary practice location
6709 Denia Dr
Austin, TX 78739-1615
Mailing address
9600 Escarpment Blvd.
Ste #745, Unit 178
Austin, TX 78749-1983
Phone (512) 777-1549
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 |
|---|---|---|---|
| 75430 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631318400000",
"number": "1164096277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9600 ESCARPMENT BLVD.",
"address_2": "STE #745, UNIT 178",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787491983",
"telephone_number": "512-777-1549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6709 DENIA DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787391615",
"telephone_number": "512-783-8625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONSALVES",
"first_name": "SHANTEL",
"middle_name": "NIKOLE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-14",
"last_updated": "2021-09-11",
"certification_date": "2021-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "75430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.