Brian Michael Gong, LMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC7820 Issued in MD

Practice address

401 Linton Blvd
Suite 200-a
Delray Beach, FL 33444

Phone

(561) 501-1008

Fax

(561) 431-2608

NPI assigned

May 31, 2017

Sex

Male

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)

Not enrolled

State licenses

Practice roles

Locations

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.

• Brian Gong Psychotherapy, LLC

  • Mental Health Counselor
  • Delray Beach, FL
  • NPI 1033614037
  NPD Authorized official
• Mangrove Therapy Group LLC

  • Mental Health Counselor
  • Delray Beach, FL
  • NPI 1942952213
  NPD Authorized official

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1295263473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 LINTON BLVD",
            "address_2": "SUITE 200-A",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "33444",
            "telephone_number": "561-501-1008",
            "fax_number": "561-431-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 LINTON BLVD",
            "address_2": "SUITE 200-A",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "33444",
            "telephone_number": "561-501-1008",
            "fax_number": "561-431-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-31",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14460",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC7820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corina Alexandra Gomez Leon
• Yenei Gomez Vega
• Laura Gomez
• Hilary Gomolin, MD
• Tristan Gregory Goncalves
• Charles Ozak Gonik, M.D.
• Audrey Fe Caingles Gonzales
• Ivis M Gonzalez Riverol
• Alexa Gonzalez
• Ana Teresa Gonzalez, BCABA

• Professional Counselor in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Professional Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.