Active NPI
Olivia Gonzales, LMFTA
- Marriage & Family Therapist
- Spokane, WA
National Provider Identifier
1316436959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 60956978
- Practice address
- 1960 N Holy Names CT
Spokane, WA 99224-5803 - Phone
- (509) 455-4968
- Fax
- (509) 455-4988
- NPI assigned
- May 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Marriage & Family Therapist | 106H00000X | 60956978 | WA | Primary |
Addresses
Primary practice location
1960 N Holy Names CT
Spokane, WA 99224-5803
Mailing address
1960 N Holy Names CT
Spokane, WA 99224-5803
Phone (509) 455-4968
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2139223 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 60956978 | WA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Family Service Counseling Program | 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.
-
dba Catholic Charities Spokane
- Community/Behavioral Health Agency
- Spokane, WA
- NPI 1366616104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578009600000",
"number": "1316436959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1960 N HOLY NAMES CT",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992245803",
"telephone_number": "509-455-4968",
"fax_number": "509-455-4988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1960 N HOLY NAMES CT",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992245803",
"telephone_number": "509-455-4968",
"fax_number": "509-455-4988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "OLIVIA",
"credential": "LMFTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-09",
"last_updated": "2020-01-03",
"certification_date": "2020-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "60956978",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2139223",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.