Active NPI
Jose Luis Gonzalez
- Professional Counselor
- Fayetteville, NC
National Provider Identifier
1811548837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 13392
- Practice address
- 1017 Hope Mills Rd
Fayetteville, NC 28304-4234 - Phone
- (910) 491-6011
- NPI assigned
- Sep 20, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | 13392 | NC | Primary |
Addresses
Primary practice location
1017 Hope Mills Rd
Fayetteville, NC 28304-4234
Mailing address
2312 Spindle Tree Dr
Fayetteville, NC 28304-4834
Phone (832) 431-7944
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 |
|---|---|---|---|
| 13392 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossbeam Counseling Centers | Professional | Current | Accepting new patients |
Locations
1017 Hope Mills Rd
Fayetteville, NC 28304
Phone (910) 491-6011
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568937600000",
"number": "1811548837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2312 SPINDLE TREE DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283044834",
"telephone_number": "832-431-7944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 HOPE MILLS RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283044234",
"telephone_number": "910-491-6011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JOSE",
"middle_name": "LUIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-20",
"last_updated": "2019-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "13392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.