Derek Ray Gonzalez, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-20081 Issued in AZ

Practice address

21397 W Terri Lee Dr
Buckeye, AZ 85396-2457

Phone

(623) 734-2224

NPI assigned

Jul 21, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Dignity Life Counseling LLC

  • Mental Health Counselor
  • Buckeye, AZ
  • NPI 1043989478
  NPD Authorized official
• Community Bridges, Inc.

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1508124488
  NPD (past)

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1326611963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21397 W TERRI LEE DR",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853962457",
            "telephone_number": "623-734-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21397 W TERRI LEE DR",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853962457",
            "telephone_number": "623-734-2224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "824 N 99th Ave",
            "address_purpose": "LOCATION",
            "city": "Avondale",
            "state": "AZ",
            "postal_code": "853235324",
            "country_code": "US",
            "telephone_number": "623-643-9678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DEREK",
        "middle_name": "RAY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-20081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lamont Gibson
• Julie Mary Terese Gill, MA
• Giving Grace Homes LLC
• GMW Rides LLC
• Golden Sun Healthcare Services, LLC
• Dionne Gonzalez
• Elizabeth Gonzalez
• Jodie Lynn Gonzalez, LPC,LISAC
• Ulises Gonzalez, LPC
• Good Health Medical, PLLC

• Professional Counselor in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.