Mrs Autumn Ashley Gonzalez, LCPC, LMHP, CAADC in Moline, IL

Mrs Autumn Ashley Gonzalez, LCPC, LMHP, CAADC is a medicare enrolled "Counselor - Professional" provider in Moline, Illinois. Her current practice location is 4101 John Deere Rd, Moline, Illinois. You can reach out to her office (for appointments etc.) via phone at (309) 762-5433.

Mrs Autumn Ashley Gonzalez is licensed to practice in Illinois (license number 180.013574) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1699339978.

Contact Information

	Mrs Autumn Ashley Gonzalez, LCPC, LMHP, CAADC
	4101 John Deere Rd, Moline, IL 61265-9951
	(309) 762-5433
	(309) 762-4481

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Autumn Ashley Gonzalez
Gender	Female
Speciality	Counselor - Professional
Location	4101 John Deere Rd, Moline, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1699339978
Provider Enumeration Date: 04/23/2019
Last Update Date: 06/27/2024

Medicare PECOS Information:

PECOS PAC ID: 9234574989
Enrollment ID: I20240304003004

Medical Identifiers

Medical identifiers for Mrs Autumn Ashley Gonzalez such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1699339978	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	(* (Not Available))	Secondary
101YA0400X	Counselor - Addiction (substance Use Disorder)	36433 (Illinois)	Secondary
101YP2500X	Counselor - Professional	108785 (Iowa)	Secondary
101YP2500X	Counselor - Professional	180.013574 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Autumn Ashley Gonzalez allows following entities to bill medicare on her behalf.

Entity Name	Pulse Counseling & Wellness Center Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245008754 PECOS PAC ID: 6608211354 Enrollment ID: O20240304002677

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Autumn Ashley Gonzalez is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Autumn Ashley Gonzalez, LCPC, LMHP, CAADC 1701 River Dr Ste 110, Moline, IL 61265-1384 Ph: (309) 762-5433	Mrs Autumn Ashley Gonzalez, LCPC, LMHP, CAADC 4101 John Deere Rd, Moline, IL 61265-9951 Ph: (309) 762-5433

Reviews and Comments

Counselor in Moline, IL

Charea Houston, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1830 6th Ave, Moline, IL 61265 Phone: 309-749-8380
Clinton Troy Merritt, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4600 3rd St, Moline, IL 61265 Phone: 708-305-4041
Jessica Ramos, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1701 River Dr Ste 110, Moline, IL 61265 Phone: 309-762-5433
Rebecca Moreno, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3919 16th St, Moline, IL 61265 Phone: 309-797-6983
Stephen Mark Draminski, L.C.P.C. Counselor Medicare: Medicare Enrolled Practice Location: 4600 3rd St, Moline, IL 61265 Phone: 309-854-2090
Hassan Baig, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4600 3rd St, Moline, IL 61265 Phone: 309-779-2245
Brooke E Montgomery, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4600 3rd St, Moline, IL 61265 Phone: 309-779-2031

Mrs Autumn Ashley Gonzalez, LCPC, LMHP, CAADC - Medicare Counselor in Moline, IL