Individual provider Active NPI

Michelle Amezaga Gonzalez, PSY.D, LMHC

  • Mental Health Counselor
  • Coral Gables, FL
National Provider Identifier
1447406517
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH9301 Issued in FL
Practice address
5915 Ponce de Leon Blvd Ste 12
Coral Gables, FL 33146-2435
Phone
(305) 972-0818
NPI assigned
Aug 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH9301 FL Primary

Addresses

Primary practice location

5915 Ponce de Leon Blvd Ste 12
Coral Gables, FL 33146-2435

Mailing address

5915 Ponce de Leon Blvd Ste 12
Coral Gables, FL 33146-2435
Phone (305) 972-0818

Other identifiers 1

IdentifierTypeStateIssuer
11962818OtherFLCAQH

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
MH9301FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Associates of Coral Gables CurrentSince Nov 6, 2022 Accepting new patients

Locations

5915 Ponce de Leon Blvd
Ste 12
Coral Gables, FL 33146
Phone (305) 344-7224

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": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1447406517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5915 PONCE DE LEON BLVD STE 12",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462435",
            "telephone_number": "305-972-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5915 PONCE DE LEON BLVD STE 12",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462435",
            "telephone_number": "305-972-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MICHELLE",
        "middle_name": "AMEZAGA",
        "name_prefix": "Dr.",
        "credential": "PSY.D, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-08",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11962818",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.