Individual provider Active NPI

Cassandra Patricia Gomez, MA

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1538328976
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3433 Broadway St NE
Suite 160
Minneapolis, MN 55413-1740
Phone
(612) 378-2363
Fax
(612) 378-2215
NPI assigned
Jun 2, 2008
Last updated
Jun 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Professional Counselor 101YP2500X

Addresses

Primary practice location

3433 Broadway St NE
Suite 160
Minneapolis, MN 55413-1740

Mailing address

3433 Broadway St NE
Suite 160
Minneapolis, MN 55413-1740
Phone (612) 378-2363

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1538328976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE",
            "address_2": "SUITE 160",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131740",
            "telephone_number": "612-378-2363",
            "fax_number": "612-378-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE",
            "address_2": "SUITE 160",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131740",
            "telephone_number": "612-378-2363",
            "fax_number": "612-378-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "CASSANDRA",
        "middle_name": "PATRICIA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.