| Erica Gonzalez, LPC | |
|
2250 S Woodworth Loop Ste 202, Palmer, AK 99645-7457 | |
| (907) 761-5800 | |
| (907) 761-5801 |
| Full Name | Erica Gonzalez |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 2250 S Woodworth Loop Ste 202, Palmer, Alaska |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033636071 | NPI | - | NPPES |
| 1003150004 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 18079-130 (Wisconsin) | Secondary |
| 101YP2500X | Counselor - Professional | 166634 (Alaska) | Primary |
| Entity Name | Providence Health & Services - Washington |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538254347 PECOS PAC ID: 8628965910 Enrollment ID: O20040302000372 |
| Mailing Address | Practice Location Address |
|---|---|
| Erica Gonzalez, LPC Po Box 4105, Portland, OR 97208-4105 Ph: (866) 907-1068 | Erica Gonzalez, LPC 2250 S Woodworth Loop Ste 202, Palmer, AK 99645-7457 Ph: (907) 761-5800 |
Daniel Ford, Counselor Medicare: Not Enrolled in Medicare Practice Location: 950 S Snodgrass Dr, Palmer, AK 99645 Phone: 907-373-4732 Fax: 907-746-4749 | |
Laelle Robison, Counselor Medicare: Not Enrolled in Medicare Practice Location: 950 S Snodgrass Dr, Palmer, AK 99645 Phone: 907-373-4732 Fax: 907-746-4749 | |
Madison Nicole Dauzart, Counselor Medicare: Not Enrolled in Medicare Practice Location: 11921 E Palmer Wasilla Hwy, Palmer, AK 99645 Phone: 907-745-2634 Fax: 907-745-4897 | |
Megan Eppelsheimer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 950 S Snodgrass Dr, Palmer, AK 99645 Phone: 907-373-4732 | |
Shelly A Wedge, L.P.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2250 S Woodworth Loop Ste 202, Palmer, AK 99645 Phone: 907-761-5800 Fax: 907-761-5801 | |
Ashley Randall, Counselor Medicare: Not Enrolled in Medicare Practice Location: 950 S Snodgrass Dr, Palmer, AK 99645 Phone: 907-373-4732 Fax: 907-746-4750 |