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General NPI Number Information
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NPI Number | 1235519489
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Entity Type | Individual
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Provider Name | RICHARD GONZALEZ MSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/03/2015
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Last Update Date | 07/11/2020
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Provider Practice Location Address
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Address Line | 2335 TAMIAMI TRL N STE 202
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City | NAPLES
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State | FL
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Zip | 34103-4457
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Country | US
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Telephone | 239-601-6011
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Fax | 239-353-6807
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Provider Business Mailing Address
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Address Line | 2335 TAMIAMI TRL N STE 202
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City | NAPLES
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State | FL
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Zip | 34103-4457
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Country | US
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Telephone | 239-601-6011
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Fax | 239-353-6807
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW15647
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License Number State | FL
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