Mia Rose Gonzales, LPC-A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

92752 Issued in TX

Practice address

4318 Woodcock Dr Ste 120
San Antonio, TX 78228-1315

Phone

(210) 571-4471

NPI assigned

May 20, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1609615814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 E PIEDRAS DR STE 140",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281425",
            "telephone_number": "210-571-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 WOODCOCK DR STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281315",
            "telephone_number": "210-571-4471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 E Piedras Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782281425",
            "country_code": "US",
            "telephone_number": "210-571-4471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "MIA",
        "middle_name": "ROSE",
        "credential": "LPC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "92752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Gonzales, MA, BCBA, LBA
• Mary Laura Gonzales, MS, CCC-SLP
• Max Gonzales
• Melanie Cheth Gonzales, LCSW
• Melissa Gamez Gonzales
• Michael R Gonzales, MD
• Mikaela Angelique Gonzales
• Mindi Gonzales, LPC
• Nancy Lee Gonzales, PMHNP
• Natalie R. Gonzales, MA, LPC

• Mental Health Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.