# GONZALES LCSW LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164984456
- **Authorized official:** MORGAN GONZALES LCSW (OWNER)
- **Authorized official phone:** (385) 434-1274

## Contact information

- **Practice address:** 61 E 1600 N, GENOLA, UT 84655-5090
- **Practice address phone:** (385) 434-1274
- **Mailing address:** 61 E 1600 N, GENOLA, UT 84655-5090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 04/04/2019
- **Last updated:** 04/04/2019