Provider Demographics
NPI:1942940382
Name:GONZALEZ, JAMES PATRICK (LPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 BIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-4406
Mailing Address - Country:US
Mailing Address - Phone:956-536-2917
Mailing Address - Fax:
Practice Address - Street 1:302 E JACKSON ST STE 101
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-6800
Practice Address - Country:US
Practice Address - Phone:956-536-2918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51480101YA0400X
TX83756101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)