Douglas Dana Goncz, CPS

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

3041 Patrick Henry Dr 2
The 4 Button Is Sticky
Seven Corners, VA 22044-2536

Phone

(703) 534-0870

Fax

(571) 395-3575

NPI assigned

Jul 2, 2008

Last updated

Apr 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1659534493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4394",
            "city": "SEVEN CORNERS",
            "state": "VA",
            "postal_code": "220440394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3041 PATRICK HENRY DR 2",
            "address_2": "THE 4 BUTTON IS STICKY",
            "city": "SEVEN CORNERS",
            "state": "VA",
            "postal_code": "220442536",
            "telephone_number": "703-534-0870",
            "fax_number": "571-395-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCZ",
        "first_name": "DOUGLAS",
        "middle_name": "DANA",
        "credential": "CPS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225600000X",
            "taxonomy_group": "",
            "desc": "Dance Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225CA2500X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor, Assistive Technology Supplier",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.