Individual
MS. JODIE LYNN GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC,LISAC
Contact information
Practice address
20430 W CARLA VISTA, BUCKEYE, AZ 85326-4698
(602) 505-3797
Mailing address
575 S 143RD AVE, GOODYEAR, AZ 85338-3005
(602) 793-7609
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-155232
AZ
101YM0800X
Mental Health Counselor
LPC-19626
AZ
101YP2500X
Professional Counselor
Primary
LPC-19626
AZ
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
10/06/2020
Last updated
07/24/2025
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