Provider Demographics
NPI:1043528862
Name:GONZALEZ, CAROLINA (LPC, LCDC)
Entity Type:Individual
Prefix:MS
First Name:CAROLINA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 371710
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79937-1710
Mailing Address - Country:US
Mailing Address - Phone:915-782-4000
Mailing Address - Fax:915-771-0920
Practice Address - Street 1:7722 N LOOP DR
Practice Address - Street 2:#1
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-2907
Practice Address - Country:US
Practice Address - Phone:915-775-4638
Practice Address - Fax:915-778-3342
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64718101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX64718OtherLPC