Healthcare Provider Details

I. General information

NPI: 1538925482
Provider Name (Legal Business Name): ALONDRA K GONZALES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2024
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 WESLEYAN RD
INDIANAPOLIS IN
46268-3166
US

IV. Provider business mailing address

2217 MARTHA ST
INDIANAPOLIS IN
46221-1420
US

V. Phone/Fax

Practice location:
  • Phone: 317-561-1326
  • Fax:
Mailing address:
  • Phone: 765-585-0831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number33011986A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: