Clarissa Andrea Gonzalez, SLP-INTERN

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

118927 Issued in TX

Practice address

13642 N Highway 183 Ste 200
Austin, TX 78750-2210

Phone

(512) 331-4115

NPI assigned

Jan 10, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Capital Therapy Group, LLC

  • Speech-Language Pathologist
  • Austin, TX
  • NPI 1982091500
  NPD (past)

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1881964666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13642 N HIGHWAY 183 STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787502210",
            "telephone_number": "512-331-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13642 N HIGHWAY 183 STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787502210",
            "telephone_number": "512-331-4115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6301 Gaston Ave Ste 750",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752143922",
            "country_code": "US",
            "telephone_number": "214-295-5374",
            "fax_number": "817-789-6849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CLARISSA",
        "middle_name": "ANDREA",
        "credential": "SLP-INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2023-09-07",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "118927",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "36677",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207164901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149984001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Briana Gonzalez, LPN
• Brisia Gonzalez, AUD
• Brooke Elizabeth Gonzalez, RN, PNP
• Carlos Javier Gonzalez Jr.
• Cassandra Gonzalez
• Clarissa Marie Gonzalez, COTA
• Crystal Joy Gonzalez
• Dana Gonzalez
• Dani Odette Gonzalez
• Dora Idalia Gonzalez, LCSW

• All providers in Austin, TX
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.