Provider Demographics
NPI:1518002757
Name:GONZALEZ, GENEVIEVE (LICSW)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LICSW
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 68
Mailing Address - Street 2:
Mailing Address - City:BOXFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01921-0068
Mailing Address - Country:US
Mailing Address - Phone:781-469-1183
Mailing Address - Fax:
Practice Address - Street 1:17A OLD TOPSFIELD RD
Practice Address - Street 2:
Practice Address - City:BOXFORD
Practice Address - State:MA
Practice Address - Zip Code:01921-2666
Practice Address - Country:US
Practice Address - Phone:781-724-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1117431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical