Provider Demographics
NPI:1558380113
Name:GONZALEZ, EFRAIN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:EFRAIN
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 DAIRY ASHFORD RD STE 601
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-3022
Mailing Address - Country:US
Mailing Address - Phone:281-645-5264
Mailing Address - Fax:210-582-6463
Practice Address - Street 1:1160 DAIRY ASHFORD RD STE 601
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-3022
Practice Address - Country:US
Practice Address - Phone:281-645-5264
Practice Address - Fax:210-582-6463
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional