Active NPI
Melissa Luke Gonzalez, PH.D.
- Intellectual & Developmental Disabilities Psychologist
- Chattanooga, TN
National Provider Identifier
1447563044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- License
- 1430
- Practice address
- 1101 Carter St
Chattanooga, TN 37402-5017 - Phone
- (423) 490-7710
- Fax
- (423) 490-7750
- NPI assigned
- Jul 23, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 04898 | MD | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 1430 | LA | Primary |
Addresses
Primary practice location
1101 Carter St
Chattanooga, TN 37402-5017
Mailing address
1101 Carter St
Chattanooga, TN 37402-5017
Phone (423) 490-7710
Other practice location 1
707 N Broadway
Baltimore, MD 21205-1832
Phone (443) 923-2817
Other practice location 2
8415 Goodwood Blvd Ste 200
Baton Rouge, LA 70806-7851
Phone (225) 765-6346
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04898 | MD | MD | Intellectual & Developmental Disabilities Psychologist |
| 1430 | LA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587686400000",
"number": "1447563044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 CARTER ST",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374025017",
"telephone_number": "423-490-7710",
"fax_number": "423-490-7750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 CARTER ST",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374025017",
"telephone_number": "423-490-7710",
"fax_number": "423-490-7750"
}
],
"practiceLocations": [
{
"address_1": "707 N Broadway",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212051832",
"country_code": "US",
"telephone_number": "443-923-2817",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8415 Goodwood Blvd Ste 200",
"address_purpose": "LOCATION",
"city": "Baton Rouge",
"state": "LA",
"postal_code": "708067851",
"country_code": "US",
"telephone_number": "225-765-6346",
"fax_number": "225-765-8585",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GONZALEZ",
"first_name": "MELISSA",
"middle_name": "LUKE",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-23",
"last_updated": "2020-04-24",
"certification_date": "2020-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "MD",
"license": "04898",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "LA",
"license": "1430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.