MICHAEL AARON GONZALEZ CADC-R/CRM/PSS NPI 1174196083

NPI Information

NPI: 1174196083
Provider Name: MICHAEL AARON GONZALEZ, CADC-R/CRM/PSS
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
620 NE 2ND ST
GRESHAM, OR
ZIP 97030
Phone: (971) 274-3757
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Michael Aaron Gonzalez, CADC-R/CRM/PSS is an addiction (substance use disorder) counselor in Gresham, OR. Michael Aaron Gonzalez, CADC-R/CRM/PSS NPI is 1174196083. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

620 NE 2ND ST
GRESHAM, OR
ZIP 97030-514
Phone: (971) 274-3757
Fax: (503) 912-5740

The enumeration date for this NPI number is 7/19/2021 and was last updated on 11/8/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	175T00000X	Peer Specialist		THW000105609	OREGON	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	21-CRM-479	OREGON	No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	T-22-1722	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500807475	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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