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MIGUEL GONZALEZ MS,OBLPCT LPC INTERN
NPI 1164904124
Counselor - Mental Health in Salem, OR

Active since September 05, 2018PECOS Enrolled
4890 32ND AVE SE, SALEM, OR 97317(503) 588-5647 Get Directions Write a Review

NPPES record last updated: September 5, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Miguel Gonzalez Ms,oblpct Lpc Intern NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIGUEL GONZALEZ MS,OBLPCT LPC INTERN (NPI 1164904124) is an individual mental health provider in Salem, Oregon and active in the NPI registry since September 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164904124
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMIGUEL GONZALEZCredential: MS,OBLPCT LPC INTERN
Location Address4890 32ND AVE SESalem, OR 97317-9350
Mailing AddressPo Box 946Philomath, OR 97370-0946 · (503) 562-9505
Phone(503) 588-5647
Sole ProprietorNo
Enumeration DateSeptember 5, 2018
✔ NPI 1164904124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
4890 32ND AVE SE, Salem, OR 97317
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miguel Gonzalez Ms,oblpct Lpc Intern is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Miguel Gonzalez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Willamette Family Medical Center Inc
3.5 mi
Family Medicine
435 LANCASTER DR NE
Salem, OR 97301
  • Reassigned Medicare billing, Oregon enrollment
  • 26 clinicians in this Medicare group
NPI 1649386418 (503) 585-6388

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DELLA M RADKE QMHA
Behavior Analyst
4890 32ND AVE SE
SALEM, OR 97317
Marion County (503) 588-5647
ALAN KEITH GUSTAFSON
Community Health Worker
4890 32ND AVE SE
SALEM, OR 97317
Marion County (503) 588-5647
CLARA EDMONDS
Counselor (Mental Health)
4890 32ND AVE SE
SALEM, OR 97317
Marion County (503) 588-5647
MRS. BETTY L WILLIS MA, LPC
Counselor (Professional)
4890 32ND AVE SE
SALEM, OR 97317
Marion County (504) 371-7393
CODY ALLYN MASK
Community Health Worker
4890 32ND AVE SE
SALEM, OR 97317
Marion County (503) 588-5647
DARA BENTON
Case Manager/Care Coordinator
4890 32ND AVE SE
SALEM, OR 97317
Marion County (503) 588-5647
KIMBERLY ANNE MARIE BOYD
Case Manager/Care Coordinator
4890 32ND AVE SE
SALEM, OR 97317
Marion County (503) 588-5647
CHRISTIAN COMMUNITY PLACEMENT CENTER
Community/Behavioral Health
4890 32ND AVE SE
SALEM, OR 97317
Marion County (503) 588-5647

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Miguel Gonzalez's NPI number?

The NPI number for Miguel Gonzalez is 1164904124. It was assigned to this individual provider in the NPPES registry on September 5, 2018.

Where is Miguel Gonzalez located?

Miguel Gonzalez practices at 4890 32nd Ave SE, Salem, OR 97317. The listed phone number is (503) 588-5647.

What is Miguel Gonzalez's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Miguel Gonzalez enrolled in Medicare?

Yes. Miguel Gonzalez is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Miguel Gonzalez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Miguel Gonzalez reassigns Medicare benefits to Willamette Family Medical Center Inc (Salem, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Miguel Gonzalez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Miguel Gonzalez accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Miguel Gonzalez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Miguel Gonzalez was last updated on September 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.