GUSTAVO GONZALEZ LPC NPI 1710574058

NPI Information

NPI: 1710574058
Provider Name: GUSTAVO GONZALEZ, LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

PECOS Registration: Yes

Address:
605 S CONROE MEDICAL DR
CONROE, TX
ZIP 77304
Phone: (936) 539-4004
Get Directions

Gustavo Gonzalez, LPC is a professional counselor in Conroe, TX with 8 years of experience. Gustavo Gonzalez, LPC NPI is 1710574058. 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:

605 S CONROE MEDICAL DR
CONROE, TX
ZIP 77304-722
Phone: (936) 539-4004
Fax: (936) 539-3635

The NPI 1710574058 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 12/21/2020 and was last updated on 5/13/2021.

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	101YP2500X	Counselor	Professional	77612	TEXAS	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	4187866-01	MEDICAID	TEXAS

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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