Jessica Gonzalez – Counselor in Independence, KS

Key facts

NPI: 1235914656
Entity type: Individual (NPI type 1)
Primary specialty: Counselor 101Y00000X
License: 01740 (KS)
Practice address: 3354 Highway 160
Independence, KS 67301-7841
Phone: (620) 331-3131
Fax: (620) 332-5110
NPI assigned: Aug 25, 2023
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Pawnee Mental Health Service, Inc. Primary Care Clinic/Center · Manhattan, KS · NPI 1356139158

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
01740	KS	MD	Counselor

Practice roles

Organization	Specialty	Status	New patients
Pawnee Mental Health Service, Inc.		Past since Sep 5, 2023	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Counselor	101Y00000X	01740	KS	Yes

Addresses

Primary practice location

3354 Highway 160
Independence, KS 67301-7841

Mailing address

2121 SW Chelsea Dr
Topeka, KS 66614-1756
Phone (785) 291-9644

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 25, 2023.

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1235914656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 SW CHELSEA DR",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666141756",
            "telephone_number": "785-291-9644",
            "fax_number": "888-977-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3354 HIGHWAY 160",
            "city": "INDEPENDENCE",
            "state": "KS",
            "postal_code": "673017841",
            "telephone_number": "620-331-3131",
            "fax_number": "620-332-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "KS",
            "license": "01740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, KS

All providers in Independence, KS · Counselor in Kansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.