Active NPI
Rebeca Gonzalez, PSY.D.
- Clinical Psychologist
- Brooklyn, NY
National Provider Identifier
1659317832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 015788-1
- Practice address
- 140 Saint Edwards St
Brooklyn, NY 11201-3904 - Phone
- (718) 858-6400
- Fax
- (718) 596-5067
- NPI assigned
- Jun 22, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 015788-1 | NY | Primary |
Addresses
Primary practice location
140 Saint Edwards St
Brooklyn, NY 11201-3904
Mailing address
1 Old Country Rd
Suite 271
Carle Place, NY 11514-1801
Phone (800) 725-6280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02532025 | Medicaid | NY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015788-1 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Psychological and Psychiatric Health SRVS, PA | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Jacksonville, NC
- NPI 1770561193
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659317832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 OLD COUNTRY RD",
"address_2": "SUITE 271",
"city": "CARLE PLACE",
"state": "NY",
"postal_code": "115141801",
"telephone_number": "800-725-6280",
"fax_number": "800-725-6380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 SAINT EDWARDS ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112013904",
"telephone_number": "718-858-6400",
"fax_number": "718-596-5067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "REBECA",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "015788-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02532025",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
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.