Provider Demographics
NPI:1447559869
Name:GONZALEZ, ROCIO (LCSW)
Entity Type:Individual
Prefix:
First Name:ROCIO
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LCSW
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 963143
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79996-3143
Mailing Address - Country:US
Mailing Address - Phone:915-822-6030
Mailing Address - Fax:915-703-3757
Practice Address - Street 1:905 NOBLE ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4739
Practice Address - Country:US
Practice Address - Phone:915-822-6030
Practice Address - Fax:915-703-3757
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX411671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX41167OtherLICENSE CLINICAL SOCIAL WORKER