Jose Gonzalez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

163569 Issued in AK

Practice address

502 Lake St
Kenai, AK 99611-6937

Phone

(907) 600-1684

Fax

(907) 308-5882

NPI assigned

Oct 17, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Beyond Limits Counseling

  • Psychiatric/Mental Health Nurse Practitioner
  • Kenai, AK
  • NPI 1073102372

  Clinical

  NPD Authorized official
• Mat-Su Mental Health LLC

  • Mental Health Counselor
  • Wasilla, AK
  • NPI 1245811819
  NPD
• Impact Psychiatric Care, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Colorado Springs, CO
  • NPI 1871035543
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1871044743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39610 RANCH PLACE",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "99611",
            "telephone_number": "907-600-1684",
            "fax_number": "907-308-5882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 LAKE ST",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996116937",
            "telephone_number": "907-600-1684",
            "fax_number": "907-308-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JOSE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-17",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09927109",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "163569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randy L Gilliland
• Timothy Gillis, LPC, LPCS, MAC, CDCI
• Geraldine Glasgow
• Glenn E. Lockwood,DDS,PC (Kenai Dental Clinic)
• Victoria Christine Goneau
• James B Goodman, DDS
• Megan Elizabeth Goodwin
• Alecia Ann Gottlob, BA
• Rowan Indica Gottlob
• Jolene M Gough

• Clinical Social Worker in Kenai, AK
• Providers in Kenai, AK by specialty
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.