Active NPI
Larissa Gonsalez Gomez, LCSW
- Clinical Social Worker
- Leander, TX
National Provider Identifier
1801507405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 40230
- Practice address
- 10824 E Crystal Falls Pkwy Ste 401
Leander, TX 78641-4301 - Phone
- (512) 567-9679
- NPI assigned
- Dec 6, 2022
- 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 | 40230 | TX | Primary |
Addresses
Primary practice location
10824 E Crystal Falls Pkwy Ste 401
Leander, TX 78641-4301
Mailing address
11005 Quarry Oaks TRL
Austin, TX 78717-4440
Phone (151) 256-7967
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | larissag@subidacounseling.com | Direct |
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
- Clinical Social Worker
- Education
- Other, 2004
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Dallas, TX 75284
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40230 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670284800000",
"number": "1801507405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11005 QUARRY OAKS TRL",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787174440",
"telephone_number": "151-256-7967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10824 E CRYSTAL FALLS PKWY STE 401",
"city": "LEANDER",
"state": "TX",
"postal_code": "786414301",
"telephone_number": "512-567-9679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "LARISSA",
"middle_name": "GONSALEZ",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-06",
"last_updated": "2022-12-06",
"certification_date": "2022-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "40230",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "larissag@subidacounseling.com",
"affiliation": "N",
"endpointDescription": "Use encryption for personal health information",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "10824 E Crystal Falls Pkwy Ste 401",
"city": "Leander",
"state": "TX",
"country_code": "US",
"postal_code": "786414301",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Leander, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.