NPIMap

Individual provider Active NPI

Alyssa Nicole Gonzales, LCSW, SSW

  • Clinical Social Worker
  • Rio Rancho, NM
National Provider Identifier
1306359369
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2023-0015 Issued in NM
Practice address
1500 Veranda Rd SE
Rio Rancho, NM 87124-3897
Phone
(055) 730-6522
NPI assigned
Nov 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X T-18-085 OR
Social Worker 104100000X M7536 OR
School Social Worker 1041S0200X M-10102 NM
Clinical Social Worker 1041C0700X SWB-2023-0015 NM Primary

Addresses

Primary practice location

1500 Veranda Rd SE
Rio Rancho, NM 87124-3897

Mailing address

1500 Veranda Rd SE
Rio Rancho, NM 87124-3897
Phone (505) 730-6522

Other identifiers 3

IdentifierTypeStateIssuer
500735164MedicaidOR
1306359369MedicaidNM
500740393MedicaidOR

Other names 1

  • Ms. Alyssa Nicole Gonzales Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
T-18-085ORMDAddiction (Substance Use Disorder) Counselor
M7536ORMDSocial Worker
SWB-2023-0015NMMDClinical Social Worker
M-10102NMMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oslc Developments, Inc. - Clinic Past Accepting new patients

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": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1306359369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 VERANDA RD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871243897",
            "telephone_number": "505-730-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 VERANDA RD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871243897",
            "telephone_number": "055-730-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "ALYSSA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "LCSW, SSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-18-085",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "M7536",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NM",
            "license": "M-10102",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2023-0015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500735164",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306359369",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500740393",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "GONZALES",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "credential": "LMSW, QMHP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.