Basilia Dawn Gonzalez

Individual provider Active NPI Case Manager/Care Coordinator · West Jefferson, OH

NPI 1811518756 · NPPES record last updated Feb 17, 2023

Key facts

NPI
1811518756
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
51 N West St Apt D
West Jefferson, OH 43162-1289
Phone
(614) 517-6508
NPI assigned
May 1, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

51 N West St Apt D
West Jefferson, OH 43162-1289

Mailing address

51 N West St Apt D
West Jefferson, OH 43162-1289
Phone (614) 517-6508

Other providers in West Jefferson, OH

All providers in West Jefferson, OH · Case Manager/Care Coordinator in Ohio

Sources for this page

Verify at the official NPI Registry.