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Provider Information for 1437524535

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

ALICIA GOMEZ LCPC

Gender: FEMALE

Individual NPI: 1437524535

Calendar   Last Updated:  2017-03-16
  Certification Date: 

Details

Name Value
NPI 1437524535
Enumeration Date 2015-12-01
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 4219 N SAWYER AVE
CHICAGO, IL 60618-1209
United States

Phone: 330-720-4256 | Fax:
View Map External Link
Primary Practice Address 4219 N SAWYER AVE
CHICAGO, IL 60618-1209
United States

Phone: 330-720-4256 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 101YP2500X - Counselor Professional IL 180.008195