Individual
EDWARD GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW & LDAC
Contact information
Practice address
627 MAIN ST, MANCHESTER, CT 06040-5181
(860) 324-0042
Mailing address
1329 BURNSIDE AVE APT B3, EAST HARTFORD, CT 06108-1575
(516) 652-2100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1090
CT
1041C0700X
Clinical Social Worker
Primary
010279
CT
Other
Enumeration date
06/18/2014
Last updated
05/12/2022
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