MEDICARE: BEATRIZ GONZALEZ MSW LISW LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	3129	NE
2	104100000X	Social Worker	06813	IA
3	1041C0700X	Clinical Social Worker	1219	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134272305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRIZ GONZALEZ MSW LISW LCSW

Provider Business Mailing Address
First Line	:	1941 S 42ND ST STE 107
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68105-2942
Country	:	US
Telephone Number	:	402-212-0027
Fax Number	:	401-300-8169

Provider Business Practice Location Address
First Line	:	1941 S 42ND ST STE 107
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68105-2942
Country	:	US
Telephone Number	:	402-212-0027
Fax Number	:	401-300-8169

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	11/28/2019

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Directions to “ BEATRIZ GONZALEZ MSW LISW LCSW” Practice Location

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