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General NPI Number Information
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NPI Number | 1689510117
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Entity Type | Individual
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Provider Name | NICOLAS GONZALEZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 122 COTTAGE ST
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City | BOSTON
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State | MA
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Zip | 02128-2290
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Country | US
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Telephone | 617-635-8510
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Fax |
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Provider Business Mailing Address
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Address Line | 82 BRISTOW ST
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City | SAUGUS
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State | MA
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Zip | 01906-2841
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Country | US
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Telephone | 617-792-3457
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | LCSW228046
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License Number State | MA
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