Provider Demographics
NPI:1427893825
Name:JOHNDAVID GONZALEZ LCSW PLLC
Entity type:Organization
Organization Name:JOHNDAVID GONZALEZ LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ILENE
Authorized Official - Middle Name:
Authorized Official - Last Name:KASWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-849-1958
Mailing Address - Street 1:2394 MARK RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-3527
Mailing Address - Country:US
Mailing Address - Phone:845-849-1958
Mailing Address - Fax:
Practice Address - Street 1:1 BRIDGE ST STE 22
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NY
Practice Address - Zip Code:10533-1551
Practice Address - Country:US
Practice Address - Phone:929-352-6384
Practice Address - Fax:888-972-5017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty