Alexandre Souza Goncalves, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

700 S Penn Avenue
Bartlesville, OK 74003-3847

Phone

(918) 200-7263

NPI assigned

Apr 28, 2011

Last updated

Jul 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grand Lake Mental Health Center, Inc.

  dba GRAND Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, OK
  • NPI 1497762520
  Medicare reassignment NPD
• Grand Lake Mental Health Center, Inc.

  dba Grand Mental Health

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1356048656
  NPD
• Grand Lake Mental Health Center, Inc.

  dba GRAND Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pryor, OK
  • NPI 1871500900
  NPD
• Creoks Mental Health Services

  dba TruHealth Integrated Care

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1710583372
  NPD (past)

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1871884536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S PENN AVENUE",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740033847",
            "telephone_number": "918-906-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PENN AVENUE",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740033847",
            "telephone_number": "918-200-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCALVES",
        "first_name": "ALEXANDRE",
        "middle_name": "SOUZA",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-28",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "5086",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Glenn
• April Dawn Goff
• Lyndsey Cheyenne Goff, B.S.
• Gold Bison Enterprises, P.C.
• William Howard Golden
• Misty Dawn Gonzales
• Jaime Gonzalez Jr.
• Lauren Goode
• Corie Goodell
• Kacandra M Goodell

• Mental Health Counselor in Bartlesville, OK
• Providers in Bartlesville, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.