Patricia Jane Gonzalez, LPC, MT-BC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PC007798 Issued in PA

Practice address

390 Reed Rd FL 1
Broomall, PA 19008-4008

Phone

(484) 450-6476

Fax

(484) 224-3398

NPI assigned

Feb 27, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectra Support Services, LLCGroup PAC ID 9133364045, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Spectra Support Services, LLC

  • Clinical Social Worker
  • Broomall, PA
  • NPI 1134482409

  Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1396085387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 S SWARTHMORE AVE",
            "city": "SWARTHMORE",
            "state": "PA",
            "postal_code": "190811606",
            "telephone_number": "267-205-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 REED RD FL 1",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190084008",
            "telephone_number": "484-450-6476",
            "fax_number": "484-224-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "PATRICIA",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "LPC, MT-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC007798",
            "primary": true
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103499164",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean Patrick Gnecco, M.D.
• Edward Joseph Golden, LCSW
• Andrew Goldenberg, DMD
• Ronald Scott Goldenberg, DMD
• Marjorie Vernette Gonzalez
• Donald R Gordon, DDS
• Christina Gormley, MA CCC-SLP
• Taylor Gormley, MA, LBS, BCBA
• Elina Igorevna Gorovaya
• Jennifer Lynn Gowdy, IBCLC

• Mental Health Counselor in Broomall, PA
• Providers in Broomall, PA by specialty
• Mental Health Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.