Active NPI
Mary Alice Gonzales, LPCA
- Mental Health Counselor
- Winston Salem, NC
National Provider Identifier
1992052880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A8900
- Practice address
- 665 W 4TH St
Winston Salem, NC 27101-2701 - Phone
- (336) 725-8389
- Fax
- (336) 714-3395
- NPI assigned
- Aug 9, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A8900 | NC | Primary |
Addresses
Primary practice location
665 W 4TH St
Winston Salem, NC 27101-2701
Mailing address
665 W 4TH St
Winston Salem, NC 27101-2701
Phone (336) 725-8389
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
| License | State | Type | Specialty |
|---|---|---|---|
| A8900 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398988800000",
"number": "1992052880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "665 W 4TH ST",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271012701",
"telephone_number": "336-725-8389",
"fax_number": "336-714-3395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "665 W 4TH ST",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271012701",
"telephone_number": "336-725-8389",
"fax_number": "336-714-3395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "MARY",
"middle_name": "ALICE",
"credential": "LPCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-09",
"last_updated": "2014-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A8900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.