Active NPI
Jennifer R Gonzalez, MA, LPC, NCC
- Professional Counselor
- Idalou, TX
National Provider Identifier
1518537877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 78314
- Practice address
- 104 E 7TH St
Idalou, TX 79329-9000 - Phone
- (281) 216-3602
- NPI assigned
- Jun 29, 2021
- Last updated
- Jun 29, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 78314 | TX | Primary |
Addresses
Primary practice location
104 E 7TH St
Idalou, TX 79329-9000
Mailing address
104 E 7TH St
Idalou, TX 79329-9000
Phone (281) 216-3602
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78314 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1518537877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 E 7TH ST",
"city": "IDALOU",
"state": "TX",
"postal_code": "793299000",
"telephone_number": "281-216-3602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 E 7TH ST",
"city": "IDALOU",
"state": "TX",
"postal_code": "793299000",
"telephone_number": "281-216-3602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JENNIFER",
"middle_name": "R",
"credential": "MA, LPC, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-29",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "78314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idalou, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.