Active NPI
Edica Gonzalez
- Clinical Social Worker
- Virginia Beach, VA
National Provider Identifier
1740854371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904014814
- Practice address
- 828 Healthy Way Ste 105
Virginia Beach, VA 23462-7958 - Phone
- (757) 965-8686
- NPI assigned
- May 18, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | 0904014814 | VA | Primary |
Addresses
Primary practice location
828 Healthy Way Ste 105
Virginia Beach, VA 23462-7958
Mailing address
941 Duck Pond Dr Apt 107
Virginia Beach, VA 23464-3318
Phone (760) 917-5671
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692144000000",
"number": "1740854371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "941 DUCK POND DR APT 107",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234643318",
"telephone_number": "760-917-5671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "828 HEALTHY WAY STE 105",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234627958",
"telephone_number": "757-965-8686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "EDICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-18",
"last_updated": "2023-08-16",
"certification_date": "2023-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904014814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
- Ruth Karina Gonzalez Mendoza, RBT
- Lorena Beatriz Gonzalez Quintero, APRN, NP
- Anna Maria Gonzalez-Hardy, M.S., LMHC, LPC
- Justice Gonzalez-Smith, BCBA, LBA
- Arturo Busante Gonzalez II, D.C.
- Hanaisa Gonzalez
- Michele Jane Gonzalez, M.D.
- Good Mourning Counseling & Consulting LLC
- Good Neighbor Dental at Great Neck
- Good Neighbor Dental at Red Mill
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.