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General NPI Number Information
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NPI Number | 1659534493
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Entity Type | Individual
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Provider Name | DOUGLAS DANA GONCZ CPS
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Gender | Male
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 3041 PATRICK HENRY DR 2 THE 4 BUTTON IS STICKY
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City | SEVEN CORNERS
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State | VA
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Zip | 22044-2536
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Country | US
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Telephone | 703-534-0870
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Fax | 571-395-3575
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Provider Business Mailing Address
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Address Line | PO BOX 4394
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City | SEVEN CORNERS
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State | VA
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Zip | 22044-0394
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Country | US
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Telephone |
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Fax |
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225CA2500X
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Taxonomy Name | Assistive Technology Supplier Rehabilitation Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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