| James L. Gonzales Counseling & Psychological Services Pc | |
|
5435 Sugarloaf Pkwy Suite 1103 Lawrenceville GA 30043-5700 | |
| (770) 995-6026 | |
| (770) 995-6084 |
| Full Name | James L. Gonzales Counseling & Psychological Services Pc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 5435 Sugarloaf Pkwy, Lawrenceville, Georgia |
| Authorized Official Name and Position | James L. Gonzales (OWNER) |
| Authorized Official Contact | 7709956026 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James L. Gonzales Counseling & Psychological Services Pc 5435 Sugarloaf Pkwy Suite 1103 Lawrenceville GA 30043-5700 Ph: (770) 995-6026 | James L. Gonzales Counseling & Psychological Services Pc 5435 Sugarloaf Pkwy Suite 1103 Lawrenceville GA 30043-5700 Ph: (770) 995-6026 |
| NPI Number | 1275808487 |
|---|---|
| Provider Enumeration Date | 03/21/2012 |
| Last Update Date | 03/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275808487 | NPI | - | NPPES |
| P00264939 | Other | GA | RAILROAD |
| 027535 | Other | GA | BLUE CROSS BLUE SHIELD |
| 00817275A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 1640 (Georgia) | Primary |
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