Individual provider Active NPI

Maria Alicia Gomez, M.S. ED

  • Mental Health Counselor
  • Rock Island, IL
National Provider Identifier
1629578075
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2701 17TH St
Rock Island, IL 61201-5351
Phone
(309) 779-2031
NPI assigned
Feb 12, 2018
Last updated
Feb 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2701 17TH St
Rock Island, IL 61201-5351

Mailing address

2701 17TH St
Rock Island, IL 61201-5351
Phone (309) 779-2031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250623001035 IL Practitioner - Mental Health Counselor 6709398191 Reassigns benefits to 1 organization
I20260225000258 IA Practitioner - Mental Health Counselor 6709398191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3125 Cottage Grove Ave
Des Moines, IA 50311-3809

3125 Cottage Grove Ave
Des Moines, IA 50311-3894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
The Robert Young Center for Community Mental Health CurrentSince Apr 16, 2025 Accepting new patients
The Robert Young Center for Community Mental Health Current Accepting new patients
Lutheran Services in Iowa, Inc. CurrentSince Dec 27, 2025 Accepting new patients
The Robert Young Center for Community Mental Health Mental Health CurrentSince Apr 16, 2025 Accepting new patients

Locations

3125 Cottage Grove Ave
Des Moines, IA 50311
Phone (515) 274-4946

2200 3rd Ave
Rock Island, IL 61201
Phone (309) 779-2094

2560 24th St
Ste 101
Rock Island, IL 61201
Phone (309) 779-3970

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1629578075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "MARIA",
        "middle_name": "ALICIA",
        "credential": "M.S. ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

Verify at the official NPI Registry.