Individual
MS. ALYSSA NICOLE GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, SSW
Contact information
Practice address
1500 VERANDA RD SE, RIO RANCHO, NM 87124-3897
(055) 730-6522
Mailing address
1500 VERANDA RD SE, RIO RANCHO, NM 87124-3897
(505) 730-6522
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
T-18-085
OR
104100000X
Social Worker
M7536
OR
1041C0700X
Clinical Social Worker
Primary
SWB-2023-0015
NM
1041S0200X
School Social Worker
M-10102
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306359369
—
NM
05
—
500735164
—
OR
05
—
500740393
—
OR
Enumeration date
11/13/2017
Last updated
01/17/2023
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