Provider Demographics
NPI:1992142368
Name:GONZALES, SONYA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:MARIE
Last Name:GONZALES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:M
Other - Last Name:GONZALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2010 NORTH LOOP W STE 115
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-8131
Mailing Address - Country:US
Mailing Address - Phone:832-285-3911
Mailing Address - Fax:855-279-3152
Practice Address - Street 1:2010 NORTH LOOP W STE 115
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8131
Practice Address - Country:US
Practice Address - Phone:832-285-3911
Practice Address - Fax:832-553-2546
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-25
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX537521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX343731103Medicaid