Active NPI
Tyffany Marie Gonzalez, LCSW
- Clinical Social Worker
- Houston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 65397
- Practice address
- 4635 Southwest Fwy Ste 635
Houston, TX 77027-7112 - Phone
- (713) 850-0049
- NPI assigned
- Nov 6, 2024
- Last updated
- Nov 6, 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 65397 | TX | Primary |
Addresses
Primary practice location
4635 Southwest Fwy Ste 635
Houston, TX 77027-7112
Mailing address
4635 Southwest Fwy Ste 635
Houston, TX 77027-7112
Phone (713) 850-0049
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65397 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Senior Psychological Care Sa I, LLC | Clinical | Current | Accepting new patients |
Locations
11127 Circle Dr
Austin, TX 78736
Phone (512) 288-8844
4635 Southwest Fwy
Ste 635
Houston, TX 77027
Phone (281) 759-2900
5027 Pecan Grove Blvd
San Antonio, TX 78222
Phone (210) 333-6815
616 W Russell Pl
San Antonio, TX 78212
Phone (210) 725-9233
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, 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": "1730851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1740003862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4635 SOUTHWEST FWY STE 635",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770277112",
"telephone_number": "713-850-0049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4635 SOUTHWEST FWY STE 635",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770277112",
"telephone_number": "713-850-0049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "TYFFANY",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-06",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "65397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.