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NPI Code Detail

MEDICARE: ALEXIA GONZALEZ M.A, LPC

MEDICARE: ALEXIA GONZALEZ M.A, LPC
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
1171M00000XCase Manager/Care Coordinator
2101YM0800XMental Health Counselor88892TX

Other Identifiers

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

General Provider Information

NPI Number : 1811523814
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIA GONZALEZ M.A, LPC
Provider Business Mailing Address
First Line : 207 SULPHUR SPRINGS RD
Second Line :
City : BRYAN
State : TX
Zip : 77801-3134
Country : US
Telephone Number : 281-846-4454
Fax Number :
Provider Business Practice Location Address
First Line : 207 SULPHUR SPRINGS RD
Second Line :
City : BRYAN
State : TX
Zip : 77801-3134
Country : US
Telephone Number : 281-846-4454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2020
Last Update Date : 01/17/2025

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