Provider Demographics
NPI:1922664382
Name:GONZALEZ, LAYNE GREGORY (MS, NCC)
Entity Type:Individual
Prefix:
First Name:LAYNE
Middle Name:GREGORY
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MS, NCC
Other - Prefix:
Other - First Name:LAYNE
Other - Middle Name:GREGORY
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, NCC
Mailing Address - Street 1:385 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-1221
Mailing Address - Country:US
Mailing Address - Phone:412-580-0413
Mailing Address - Fax:
Practice Address - Street 1:260 OHIO RIVER BLVD
Practice Address - Street 2:
Practice Address - City:BADEN
Practice Address - State:PA
Practice Address - Zip Code:15005-1914
Practice Address - Country:US
Practice Address - Phone:724-869-2023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-11
Last Update Date:2019-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional