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1699260653 NPI number — CHRIS E GONZALES MS, NCC, LPC

NPI Number: 1699260653
Health Care Provider/Practitioner: CHRIS E GONZALES MS, NCC, LPC

Information about “1699260653” NPI (CHRIS E GONZALES MS, NCC, LPC) exists in 1699260653 in HTML format HTML  |  1699260653 in plain Text format TXT  |  1699260653 in PDF (Portable Document Format) PDF  |  1699260653 in an XML format XML  formats.

NPI Number : 1699260653 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1699260653",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GONZALES",
    "FirstName": "CHRIS",
    "MiddleName": "E",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "MS, NCC, LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GONZALES",
    "OtherFirstName": "CHRISTOPHER",
    "OtherMiddleName": "E",
    "OtherNamePrefix": "MR.",
    "OtherNameSuffix": null,
    "OtherCredential": "MS, NCC, LPC",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "1484 CAMBRIA DR UNIT 4",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DEKALB",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60115-1084",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "630-267-2728",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "106 S. LINCOLNWAY",
    "SecondLinePracticeLocationAddress": "F",
    "PracticeLocationAddressCityName": "NORTH AURORA",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60542-1663",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "630-267-2728",
    "PracticeLocationAddressFaxNumber": "630-801-1675",
    "EnumerationDate": "06/22/2018",
    "LastUpdateDate": "06/22/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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