Amanda Jae Gonzalez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9430005-3501 Issued in UT

Practice address

5814 S 900 E
Murray, UT 84121-1644

Phone

(385) 800-3272

Fax

(385) 800-3260

NPI assigned

Aug 10, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

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 and National Provider Directory roles.

• Mostly Psych, PLLC

  • Adult Mental Health Clinic/Center
  • Murray, UT
  • NPI 1215787411
  NPD Authorized official
• Psychological Preventative Health PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idaho Falls, ID
  • NPI 1649808767
  NPD

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689465600000",
    "number": "1942515317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5814 S 900 E",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841211644",
            "telephone_number": "801-550-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5814 S 900 E",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841211644",
            "telephone_number": "385-800-3272",
            "fax_number": "385-800-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "AMANDA",
        "middle_name": "JAE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2023-07-16",
        "certification_date": "2023-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "9430005-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Gomez Lopez
• Cherai Gomez
• Tony Gongaware
• Marc Christopher Santos Gonzales, DPM
• Ranae Michelle Gonzales, AGACNP-BC
• Cynthia Gonzalez, CSUDC
• Jared Alex Gonzalez, PHARMD
• Greg R. Goodman, MD
• Lillian H. Goodman, MD
• Samantha Goodrich, MASTERS OF SCIENCE

• Clinical Social Worker in Murray, UT
• Providers in Murray, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2023; 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.