Provider Demographics
NPI:1972828689
Name:GONZALEZ, ORLANDO (TLMHC, LPC)
Entity type:Individual
Prefix:
First Name:ORLANDO
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:TLMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 S TELSHOR BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4889
Mailing Address - Country:US
Mailing Address - Phone:575-556-8470
Mailing Address - Fax:
Practice Address - Street 1:1690 S TELSHOR BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4889
Practice Address - Country:US
Practice Address - Phone:575-556-8470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0129941101YM0800X
TX65222101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health