Individual provider Active NPI

Leo Gonzalez, LPC

  • Mental Health Counselor
  • Carrollton, TX
National Provider Identifier
1962086504
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
84592 Issued in TX
Practice address
2225 Parker Rd
Carrollton, TX 75010-4711
Phone
(214) 325-6629
NPI assigned
May 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 84592 TX Primary

Addresses

Primary practice location

2225 Parker Rd
Carrollton, TX 75010-4711

Mailing address

4001 Ross Ave Apt 450
Dallas, TX 75204-5278
Phone (214) 325-6629

Other practice location 1

4054 McKinney Ave Ste 102
Dallas, TX 75204-2050
Phone (214) 520-6308

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
84592TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Counseling Center Inc CurrentSince May 1, 2021 Accepting new patients

Locations

4054 McKinney Ave
Ste 102
Dallas, TX 75204
Phone (214) 520-6308

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1962086504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 ROSS AVE APT 450",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752045278",
            "telephone_number": "214-325-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 PARKER RD",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104711",
            "telephone_number": "214-325-6629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4054 McKinney Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752042050",
            "country_code": "US",
            "telephone_number": "214-520-6308",
            "fax_number": "214-521-9172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LEO",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-10",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "84592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.