Jose Domingo Gonzalez, CDCA is a
Social Worker - Clinical based in Youngstown, Ohio. Jose Domingo Gonzalez is licensed to practice in Ohio (license number S.2411071) and his current practice location is
725 Boardman Canfield Rd Ste C4, Youngstown, Ohio. He can be reached at his office (for appointments etc.) via phone at
(855) 292-9778.
NPI number for Jose Domingo Gonzalez is 1710697321 and his current mailing address is 725 Boardman Canfield Rd Ste C4, Youngstown, Ohio. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1710697321.
Healthcare Provider's Profile
| Full Name | Jose Domingo Gonzalez |
|---|
| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 725 Boardman Canfield Rd Ste C4, Youngstown, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1710697321
- Provider Enumeration Date: 12/05/2022
- Last Update Date: 12/03/2024
Medical Identifiers
Medical identifiers for Jose Domingo Gonzalez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1710697321 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CDCA.182780 (Ohio) | Secondary |
| 175T00000X | Peer Specialist | APS.003735 (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | S.2411071 (Ohio) | Primary |
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. Jose Domingo Gonzalez is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jose Domingo Gonzalez, CDCA
725 Boardman Canfield Rd Ste C4,
Youngstown, OH 44512-4367
Ph: (855) 292-9778 | Jose Domingo Gonzalez, CDCA
725 Boardman Canfield Rd Ste C4,
Youngstown, OH 44512-4367
Ph: (855) 292-9778 |
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