Mary Theresa Gonzalez, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

RN256859L Issued in PA

Practice address

128 N Lincoln Ave
Newtown, PA 18940-2214

Phone

(215) 860-0629

Fax

(215) 860-0629

NPI assigned

Dec 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Registered Nurse

State licenses

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1396928487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 N LINCOLN AVE",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189402214",
            "telephone_number": "215-860-0629",
            "fax_number": "215-860-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 N LINCOLN AVE",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189402214",
            "telephone_number": "215-860-0629",
            "fax_number": "215-860-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-11",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "PA",
            "license": "RN256859L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "83-07571",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BLUE SHIELD",
            "identifier": "GO509036",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Goldenwood Services, LLC
• Alison Goldstein, MS, LPC, ATR-BC
• Golf Performance PT LLC
• Yuliya Gonchar
• Twain Gonzales, PSY.D.
• Bruce A. Goodman, MD
• Elise Goodman
• Goodwill Caring Healthcare Services
• Dora Goodwill
• Lauren Goodwin, M.ED, LBS

• Adult Psychiatric/Mental Health Registered Nurse in Newtown, PA
• Providers in Newtown, PA by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.