Provider Demographics
NPI:1093334542
Name:GONZALEZ, ALESIA (LPC)
Entity Type:Individual
Prefix:
First Name:ALESIA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10824 E CRYSTAL FALLS PKWY STE 401
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-4300
Mailing Address - Country:US
Mailing Address - Phone:512-775-2026
Mailing Address - Fax:
Practice Address - Street 1:10824 E CRYSTAL FALLS PKWY STE 401
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-4300
Practice Address - Country:US
Practice Address - Phone:512-522-4756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-14
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73130101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional