Individual
JOSE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
502 LAKE ST, KENAI, AK 99611-6937
(907) 600-1684
(907) 308-5882
Mailing address
39610 RANCH PLACE, KENAI, AK 99611
(907) 600-1684
(907) 308-5882
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
163569
AK
1041C0700X
Clinical Social Worker
CSW.09927109
CO
Other
Enumeration date
10/17/2016
Last updated
10/30/2024
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