Provider Demographics
NPI:1083023915
Name:GONZALEZ, ANGELICA MARIA (LMHC)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:MARIA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MISS
Other - First Name:ANGELICA
Other - Middle Name:MARIA
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:301 ALMERIA AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5822
Mailing Address - Country:US
Mailing Address - Phone:305-458-0810
Mailing Address - Fax:
Practice Address - Street 1:301 ALMERIA AVE STE 230
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5822
Practice Address - Country:US
Practice Address - Phone:305-458-0810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9419101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health