Antoinette Gonsalves, MACP

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

Practice address

4 Neshaminy Interplex Dr Ste 202
Trevose, PA 19053-6940

Phone

(323) 829-1022

NPI assigned

Feb 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Pennhurst Group LLC

  • Community/Behavioral Health Agency
  • Bala Cynwyd, PA
  • NPI 1265687867
  NPD (past)

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1295292373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 DUNKSFERRY RD APT H104",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190202734",
            "telephone_number": "323-829-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 NESHAMINY INTERPLEX DR STE 202",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536940",
            "telephone_number": "323-829-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONSALVES",
        "first_name": "ANTOINETTE",
        "credential": "MACP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Carley Erin Goldman, PA-C
• Kristi Goodwin, MSPH, CHES
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• Larry Steven Hahn, D.O.

• Cognitive & Behavioral Psychologist in Trevose, PA
• Providers in Trevose, PA by specialty
• Cognitive & Behavioral Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.