Individual provider Active NPI

Thomas Edward Gonzalez, LCSW-R

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1942622758
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081508 Issued in NY
Practice address
3265 Johnson Ave
Suite 204
Bronx, NY 10463-3539
Phone
(917) 573-1387
NPI assigned
Jan 13, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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 081508 NY Primary

Addresses

Primary practice location

3265 Johnson Ave
Suite 204
Bronx, NY 10463-3539

Mailing address

5800 Arlington Ave
Apt. 19D
Bronx, NY 10471-1402
Phone (917) 573-1387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
081508NYMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1942622758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 ARLINGTON AVE",
            "address_2": "APT. 19D",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711402",
            "telephone_number": "917-573-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3265 JOHNSON AVE",
            "address_2": "SUITE 204",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104633539",
            "telephone_number": "917-573-1387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "THOMAS",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-13",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.