Individual provider Active NPI

Jessica Yvonne Gonzalez

  • Clinical Social Worker
  • Enfield, CT
National Provider Identifier
1902703069
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
230628 Issued in MA
Practice address
612 Hazard Ave Apt 110
Enfield, CT 06082-4777
Phone
(860) 234-9864
NPI assigned
Oct 22, 2026
Last updated
Oct 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 230628 MA Primary

Addresses

Primary practice location

612 Hazard Ave Apt 110
Enfield, CT 06082-4777

Mailing address

612 Hazard Ave Apt 110
Enfield, CT 06082-4777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1792627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "number": "1902703069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 HAZARD AVE APT 110",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 HAZARD AVE APT 110",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824777",
            "telephone_number": "860-234-9864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JESSICA",
        "middle_name": "YVONNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-22",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "230628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.