Evangeline Gonzales, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-08897 Issued in NM

Practice address

7400 Hancock CT NE Ste a
Albuquerque, NM 87109-4592

Phone

(505) 206-1109

NPI assigned

Jul 17, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 20, 2024 through May 20, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Inner Healing Counseling, LLC

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1700383627
  NPD (past) Authorized official

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1699159897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44656",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871744656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 HANCOCK CT NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094592",
            "telephone_number": "505-206-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "EVANGELINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-17",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-08897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2287129",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denise Gonzales, MD
• Destenie Gonzales
• Dominic Gonzales
• Doreen Gonzales
• Edwin F Gonzales, RPH
• Evangeline Gonzales
• Fermin Gonzales Jr., CPSW, CCSS
• Gabrielle Gonzales
• Hannah Gonzales
• Helen Gonzales

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.