Provider Demographics
NPI:1750769030
Name:GONZALEZ, KEREN Y (LPC)
Entity type:Individual
Prefix:
First Name:KEREN
Middle Name:Y
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KEREN
Other - Middle Name:Y
Other - Last Name:GONZALEZ-MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3025 HAMAKER CT STE 450
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2237
Mailing Address - Country:US
Mailing Address - Phone:703-204-9100
Mailing Address - Fax:
Practice Address - Street 1:3025 HAMAKER CT STE 450
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2237
Practice Address - Country:US
Practice Address - Phone:703-204-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010869101YM0800X
DCPRC14636101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional