Individual provider Active NPI

Daniel Gonzales, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1285264903
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-11895 Issued in NM
Practice address
4010 Carlisle Blvd NE Ste F
Albuquerque, NM 87107-4532
Phone
(505) 301-5297
Fax
(505) 554-3435
NPI assigned
Jan 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C-11895 NM Primary

Addresses

Primary practice location

4010 Carlisle Blvd NE Ste F
Albuquerque, NM 87107-4532

Mailing address

4010 Carlisle Blvd NE Ste F
Albuquerque, NM 87107-4532
Phone (505) 301-5297

Other identifiers 1

IdentifierTypeStateIssuer
28428862MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20230831000767 NM Practitioner - Clinical Social Worker 9032572524 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Roots Therapy LLC Social Worker CurrentSince Jul 5, 2023 Accepting new patients

Locations

306 Washington St SE
Albuquerque, NM 87108
Phone (505) 456-5400

1420 Carlisle Blvd NE
Ste 103
Albuquerque, NM 87110

4010 Carlisle Blvd NE
Ste F
Albuquerque, NM 87107
Phone (505) 301-5297

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.

NPI Registry JSON

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1285264903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 CARLISLE BLVD NE STE F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074532",
            "telephone_number": "505-301-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 CARLISLE BLVD NE STE F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074532",
            "telephone_number": "505-301-5297",
            "fax_number": "505-554-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "DANIEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-22",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-11895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28428862",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.