Active NPI
Cynthia Machelle Gonzalez, CADC II, QMHA-C
- Addiction (Substance Use Disorder) Counselor
- Seaside, OR
National Provider Identifier
1821615832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 17-P-11
- Practice address
- 925 Avenue S Unit 1
Seaside, OR 97138-7780 - Phone
- (503) 440-8687
- NPI assigned
- Jun 25, 2020
- Last updated
- Jun 25, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 17-P-11 | NU | Primary |
| Mental Health Counselor | 101YM0800X | 1-QMHA-1-00261 | OR |
Addresses
Primary practice location
925 Avenue S Unit 1
Seaside, OR 97138-7780
Mailing address
PO Box 503
Warrenton, OR 97146-0503
Phone (503) 440-8687
Other names 1
- Cynthia Machelle Davis
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | pulse | Direct |
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 |
|---|---|---|---|
| 1-QMHA-1-00261 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593043200000",
"number": "1821615832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 503",
"city": "WARRENTON",
"state": "OR",
"postal_code": "971460503",
"telephone_number": "503-440-8687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 AVENUE S UNIT 1",
"city": "SEASIDE",
"state": "OR",
"postal_code": "971387780",
"telephone_number": "503-440-8687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "CYNTHIA",
"middle_name": "MACHELLE",
"credential": "CADC II, QMHA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-25",
"last_updated": "2020-06-25",
"certification_date": "2020-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NU",
"license": "17-P-11",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "1-QMHA-1-00261",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "pulse",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "pulse",
"address_1": "925 Avenue S Unit 1",
"city": "Seaside",
"state": "OR",
"country_code": "US",
"postal_code": "971387780",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "CYNTHIA",
"last_name": "DAVIS",
"middle_name": "MACHELLE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Seaside, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.