Individual provider Active NPI

Lucia Gonzales, LPC

  • Professional Counselor
  • The Dalles, OR
National Provider Identifier
1205156452
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C2110 Issued in OR
Practice address
419 E 7TH St Ste 207
The Dalles, OR 97058-2676
Phone
(541) 296-5452
NPI assigned
Jun 9, 2010
Last updated
Jun 9, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C2110 OR Primary

Addresses

Primary practice location

419 E 7TH St Ste 207
The Dalles, OR 97058-2676

Mailing address

419 E 7TH St Ste 207
The Dalles, OR 97058-2676
Phone (541) 296-5452

Other identifiers 1

IdentifierTypeStateIssuer
139670MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20260216001124 OR Practitioner - Mental Health Counselor 0244710655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12636 SE Stark St Plaza 125 BLDG J
Portland, OR 97233-1058
Phone (503) 253-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C2110ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC CurrentSince Dec 6, 2025 Accepting new patients
Western Psychological and Counseling Services LLC Professional CurrentSince Dec 6, 2025 Accepting new patients
Mid-Columbia Center for Living Past Accepting new patients

Locations

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

12636 SE Stark St
Bldg J
Portland, OR 97233
Phone (503) 253-4600

3500 NE Mlk Jr Blvd
Ste 200
Portland, OR 97212
Phone (503) 327-8205

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.luciagonzales@148835.advancedmd-direct.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1205156452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 E 7TH ST STE 207",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970582676",
            "telephone_number": "541-296-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 E 7TH ST STE 207",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970582676",
            "telephone_number": "541-296-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "LUCIA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C2110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139670",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Dalles, OR

Sources for this page

Verify at the official NPI Registry.