Provider Demographics
NPI:1699260653
Name:GONZALES, CHRIS E (MS, NCC, LPC)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:E
Last Name:GONZALES
Suffix:
Gender:M
Credentials:MS, NCC, LPC
Other - Prefix:MR
Other - First Name:CHRISTOPHER
Other - Middle Name:E
Other - Last Name:GONZALES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, NCC, LPC
Mailing Address - Street 1:1484 CAMBRIA DR UNIT 4
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-1084
Mailing Address - Country:US
Mailing Address - Phone:630-267-2728
Mailing Address - Fax:
Practice Address - Street 1:106 S. LINCOLNWAY
Practice Address - Street 2:F
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-1663
Practice Address - Country:US
Practice Address - Phone:630-267-2728
Practice Address - Fax:630-801-1675
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YA0400X, 101YP2500X, 101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor