Active NPI
Jennifer Gonzalez
- Professional Counselor
- Las Vegas, NV
National Provider Identifier
1679123244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CP5181
- Practice address
- 6064 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5350 - Phone
- (702) 940-8007
- Fax
- (702) 832-1940
- NPI assigned
- Sep 16, 2019
- Last updated
- May 20, 2024
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CP5181 | NV | Primary |
Addresses
Primary practice location
6064 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5350
Mailing address
6064 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5350
Phone (702) 940-8007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- University of Nevada, Las Vegas School of Medicine, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
6064 S Fort Apache Rd
Suite 100
Las Vegas, NV 89148-5350
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP5181 | NV | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J H Daulat DO PC | Past | Accepting new patients | |
| Battle-Born Psychological Services, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Psychologist
- North Las Vegas, NV
- NPI 1912377482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1679123244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6064 S FORT APACHE RD STE 100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891485350",
"telephone_number": "702-940-8007",
"fax_number": "702-832-1940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6064 S FORT APACHE RD STE 100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891485350",
"telephone_number": "702-940-8007",
"fax_number": "702-832-1940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-16",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NV",
"license": "CP5181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.