Provider Demographics
NPI:1346839511
Name:GONZALEZ, ADRIAN MANUEL (LPC)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:MANUEL
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 DUNIVEN CIR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1625
Mailing Address - Country:US
Mailing Address - Phone:806-681-7657
Mailing Address - Fax:
Practice Address - Street 1:2912 DUNIVEN CIR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1625
Practice Address - Country:US
Practice Address - Phone:806-681-7657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81360101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional