Individual
ENRIQUE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDP
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 274-2500
Mailing address
528 N MAIN ST, PROVIDENCE, RI 02904-5757
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDP00368
RI
104100000X
Social Worker
Primary
CSW02903
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104847946
THE PROVIDENCE CENTER NPI
RI
01
—
1427079086
UBH
RI
05
—
EG58355
—
RI
Enumeration date
07/21/2006
Last updated
11/16/2022
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