MEDICARE: ELSA ERIKA GOMEZ MA, LPC, LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	CTB-2022-0809	NM
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	11367	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336570704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELSA ERIKA GOMEZ MA, LPC, LPCC

Provider Business Mailing Address
First Line	:	8461 CASTNER DR TRLR 71
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-1612
Country	:	US
Telephone Number	:	915-478-2441
Fax Number	:	915-850-0249

Provider Business Practice Location Address
First Line	:	5760 W LITTLE YORK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-1112
Country	:	US
Telephone Number	:	281-707-7359
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2013
Last Update Date	:	05/15/2024

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