Individual provider Active NPI

Lori Gonzalez, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Austin, TX
National Provider Identifier
1912359456
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
12721 Issued in TX
Practice address
2600 W Stassney LN
Austin, TX 78745-3401
Phone
(512) 729-8522
Fax
(866) 653-5142
NPI assigned
Jul 8, 2016
Last updated
Nov 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 12721 TX
Addiction (Substance Use Disorder) Counselor 101YA0400X 12721 TX Primary
Mental Health Counselor 101YM0800X 12721 TX
Professional Counselor 101YP2500X 76387 TX

Addresses

Primary practice location

2600 W Stassney LN
Austin, TX 78745-3401

Mailing address

10109 Deer Chase TRL
Austin, TX 78747-2763
Phone (512) 767-8042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20240425001631 TX Practitioner - Mental Health Counselor 1850731753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deep Eddy Psychotherapy Management, LLCGroup PAC ID 2264886936, 70 clinicians

Practice addresses (Care Compare)

2600 W Stassney LN
Austin, TX 78745-3401
Phone (512) 956-6463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12721TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Deep Eddy Psychotherapy Management, LLC CurrentSince Apr 17, 2024 Accepting new patients
Beat AIDS Coalition Trust Past Accepting new patients
Beat AIDS Coalition Trust Counselor Past Accepting new patients
Deep Centered Psychiatry PLLC Past Accepting new patients

Locations

2600 W Stassney Ln
Austin, TX 78745
Phone (512) 729-8522

508 Deep Eddy Ave
Austin, TX 78703
Phone (512) 469-0889

1922 Dry Creek Way
Ste 108
San Antonio, TX 78259
Phone (512) 887-3993

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1912359456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10109 DEER CHASE TRL",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787472763",
            "telephone_number": "512-767-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 W STASSNEY LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787453401",
            "telephone_number": "512-729-8522",
            "fax_number": "866-653-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LORI",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "12721",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12721",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "12721",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "76387",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.