Sandra L Gonzales, SAA
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Silver City, NM
NPI 1932207263 · NPPES record last updated Jan 4, 2024
Key facts
- NPI
- 1932207263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 0124031 (NM)
- Practice address
- 1311 N Grant St Ste a
Silver City, NM 88061-5134 - Phone
- (575) 388-1447
- Fax
- (575) 388-1447
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240318003562 | NM | Practitioner - Mental Health Counselor | 5092152777 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0124031 | NM | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Recovery Management Center, PC | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
| The Recovery Management Center | Addiction (Substance Use Disorder) | Current | Accepting new patients |
| Recovery and Resiliency Services | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
Locations
101 S Copper St
Deming, NM 88030
Phone (575) 590-8886
603 Hadeco Dr
Lordsburg, NM 88045
Phone (575) 542-3539
1311 N Grant St
Ste A
Silver City, NM 88061
Phone (575) 388-1447
118 W 13th St
Silver City, NM 88061
Phone (575) 388-1447
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0124031 | NM | Yes |
Addresses
Primary practice location
1311 N Grant St Ste a
Silver City, NM 88061-5134
Mailing address
1311 N Grant St Ste a
Silver City, NM 88061-5134
Phone (575) 388-1447
Other practice location 1
118 W 13th St
Silver City, NM 88061-5139
Phone (575) 388-1447
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18677037 | Medicaid | NM |
Other providers in Silver City, NM
- Gentry Gilpin
- Jay Howard Glickman
- Magali Galilea Gomez
- Marissa Alisha Gomez
- Sachiko Gomi
- Tracy L Gonzales
- Frida Gonzalez
- Julie Barbara Good
- Douglas D Gorthy
- Kathy Gorum
All providers in Silver City, NM · Addiction (Substance Use Disorder) Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.