Active NPI
Gabriella Gomez, M.S., L.P.C.
- Professional Counselor
- Douglasville, GA
National Provider Identifier
1558434969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC002714
- Practice address
- 8309 Office Park Dr
Suite a
Douglasville, GA 30134-6935 - Phone
- (770) 577-2929
- Fax
- (770) 562-2759
- NPI assigned
- Nov 15, 2006
- 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 | LPC002714 | GA | Primary |
Addresses
Primary practice location
8309 Office Park Dr
Suite a
Douglasville, GA 30134-6935
Mailing address
PO Box 52
Temple, GA 30179-0052
Phone (770) 577-2929
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PVPB106934 | Other | GA | APS PROVIDER # |
| 022538 | Other | GA | VMC PROVIDER # |
| 2044180 | Other | GA | CIGNA PROVIDER # |
| 7200230 | Other | GA | AETNA PROVIDER NUMBER |
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC002714 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558434969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 52",
"city": "TEMPLE",
"state": "GA",
"postal_code": "301790052",
"telephone_number": "770-577-2929",
"fax_number": "770-562-2759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8309 OFFICE PARK DR",
"address_2": "SUITE A",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301346935",
"telephone_number": "770-577-2929",
"fax_number": "770-562-2759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "GABRIELLA",
"name_prefix": "Ms.",
"credential": "M.S., L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC002714",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APS PROVIDER #",
"identifier": "PVPB106934",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VMC PROVIDER #",
"identifier": "022538",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROVIDER #",
"identifier": "2044180",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER NUMBER",
"identifier": "7200230",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.