Individual provider Active NPI

Jodie Lynn Gonzalez, LPC,LISAC

  • Professional Counselor
  • Buckeye, AZ
National Provider Identifier
1215534946
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-19626 Issued in AZ
Practice address
20430 W Carla Vista
Buckeye, AZ 85326-4698
Phone
(602) 505-3797
NPI assigned
Oct 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LISAC-155232 AZ
Mental Health Counselor 101YM0800X LPC-19626 AZ
Professional Counselor 101YP2500X
Professional Counselor 101YP2500X LPC-19626 AZ Primary

Addresses

Primary practice location

20430 W Carla Vista
Buckeye, AZ 85326-4698

Mailing address

575 S 143Rd Ave
Goodyear, AZ 85338-3005
Phone (602) 793-7609

Other practice location 1

13925 W Meeker Blvd Ste 9
Sun City West, AZ 85375-4431
Phone (480) 780-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250820001407 AZ Practitioner - Mental Health Counselor 1759880289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2850 N Country Club Rd
Tucson, AZ 85716-1910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LISAC-155232AZMDAddiction (Substance Use Disorder) Counselor
LPC-19626AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Escalera Health LLC CurrentSince Sep 8, 2025 Accepting new patients
Kokoro Transitional Recovery and Counseling Services Addiction (Substance Use Disorder) CurrentSince Nov 24, 2024 Accepting new patients

Locations

575 S 143rd Ave
Goodyear, AZ 85338
Phone (602) 793-7609

13925 W Meeker Blvd
Ste 9
Sun City West, AZ 85375
Phone (480) 780-3030

2850 N Country Club Rd
Tucson, AZ 85716
Phone 52032262747104

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1215534946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 S 143RD AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853383005",
            "telephone_number": "602-793-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20430 W CARLA VISTA",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853264698",
            "telephone_number": "602-505-3797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13925 W Meeker Blvd Ste 9",
            "address_purpose": "LOCATION",
            "city": "Sun City West",
            "state": "AZ",
            "postal_code": "853754431",
            "country_code": "US",
            "telephone_number": "480-780-3030",
            "fax_number": "480-780-0406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JODIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LPC,LISAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-155232",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-19626",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-19626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

Verify at the official NPI Registry.