Alexandria Gonzalez, LMSW, CASAC-ADV

Primary specialty

Social WorkerTaxonomy code 104100000X

License

118711 Issued in NY

Practice address

2 Coraci Blvd Ste 15&16
Shirley, NY 11967-4833

Phone

(631) 315-2320

Fax

(631) 315-9473

NPI assigned

Nov 13, 2019

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)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: agonzalez@victoryrecovery.medentdirect.com

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686441600000",
    "number": "1215572367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 S WILLIAM ST",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117725916",
            "telephone_number": "603-966-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CORACI BLVD STE 15&16",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119674833",
            "telephone_number": "631-315-2320",
            "fax_number": "631-315-9473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Main St",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772278",
            "country_code": "US",
            "telephone_number": "631-403-6855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ALEXANDRIA",
        "name_prefix": "Mrs.",
        "credential": "LMSW, CASAC-ADV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2023-06-11",
        "certification_date": "2023-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "35312",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "118711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Giambanco, OTR/L
• Jacquelyn M. Gilde, LCSW
• Alyssa M Gilmore
• Natalie Givargidze, NP
• Selena Goetschius, LPN
• Jillian C Gonzalez, MS
• Raven Gonzalez
• Kelly Jean Gormley, LPN
• Karey Gosevski, RN
• Gotham Health Transit LLC

• Social Worker in Shirley, NY
• Providers in Shirley, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2023; 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.