Individual provider Active NPI

Kristine Kay Gonzalez, MS

  • Professional Counselor
  • Universal City, TX
National Provider Identifier
1982366886
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
81290 Issued in TX
Practice address
433 Kitty Hawk Rd Ste 219
Universal City, TX 78148-3829
Phone
(210) 566-1280
Fax
(210) 579-8533
NPI assigned
Oct 7, 2021
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 81290 TX Primary

Addresses

Primary practice location

433 Kitty Hawk Rd Ste 219
Universal City, TX 78148-3829

Mailing address

433 Kitty Hawk Rd Ste 219
Universal City, TX 78148-3829
Phone (210) 566-1280

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
I20241206002402 TX Practitioner - Mental Health Counselor 9739615220 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Alba Wellness Incorporated Professional CurrentSince Nov 3, 2024 Accepting new patients
Alba Wellness Case Management LLC PastSince Oct 10, 2021 Accepting new patients

Locations

433 Kitty Hawk Rd
Ste 219
Universal Cty, TX 78148
Phone (210) 566-1280

Organizations & group practices 2

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": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1982366886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 KITTY HAWK RD STE 219",
            "city": "UNIVERSAL CITY",
            "state": "TX",
            "postal_code": "781483829",
            "telephone_number": "210-566-1280",
            "fax_number": "210-579-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 KITTY HAWK RD STE 219",
            "city": "UNIVERSAL CITY",
            "state": "TX",
            "postal_code": "781483829",
            "telephone_number": "210-566-1280",
            "fax_number": "210-579-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "KRISTINE",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "81290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Universal City, TX

Sources for this page

Verify at the official NPI Registry.