MEDICARE: MELANIE GONSALVES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	1041C0700X	Clinical Social Worker	TX
2	1041C0700X	Clinical Social Worker	MA
3	1041C0700X	Clinical Social Worker	ME
4	1041C0700X	Clinical Social Worker	CT

General Provider Information

NPI Number	:	1629540265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE GONSALVES

Provider Business Mailing Address
First Line	:	PO BOX 141213
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78714-1213
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4601 W GUADALUPE ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78751-3146
Country	:	US
Telephone Number	:	512-424-6500
Fax Number	:

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

Provider Enumeration Date	:	12/20/2018
Last Update Date	:	02/10/2026

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Directions to “ MELANIE GONSALVES ” Practice Location

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