Active NPI
Amante Jordan Gonzalez, LLPC
- Professional Counselor
- Stevensville, MI
National Provider Identifier
1760959464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401016896
- Practice address
- 5675 Fairview St
Stevensville, MI 49127-1033 - Phone
- (269) 429-7727
- NPI assigned
- Oct 31, 2018
- Sex
- Male
- 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 | 6401016896 | MI | Primary |
Addresses
Primary practice location
5675 Fairview St
Stevensville, MI 49127-1033
Mailing address
4411 International CT Apt A47
Berrien Springs, MI 49103-1720
Phone (269) 944-9230
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401016896 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540944000000",
"number": "1760959464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4411 INTERNATIONAL CT APT A47",
"city": "BERRIEN SPRINGS",
"state": "MI",
"postal_code": "491031720",
"telephone_number": "269-944-9230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5675 FAIRVIEW ST",
"city": "STEVENSVILLE",
"state": "MI",
"postal_code": "491271033",
"telephone_number": "269-429-7727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "AMANTE",
"middle_name": "JORDAN",
"credential": "LLPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-31",
"last_updated": "2018-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401016896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stevensville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.