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Individual
JEANNA P. GOMEZ
Active
Individual
JEANNA P. GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LISW, LADAC,
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3654
NM
104100000X
Social Worker
I04876
NM
1041C0700X
Clinical Social Worker
Primary
41875
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06332803
—
NM
05
—
181965802
—
TX
Enumeration date
07/06/2006
Last updated
10/01/2008
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