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FAWN GONZALES LCSW LLC
NPI 1417322231
Social Worker - Clinical in Medford, OR

Active since December 04, 2015
14 COTTAGE ST, MEDFORD, OR 97504(541) 944-7711 Get Directions Write a Review

NPPES record last updated: December 4, 2015. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Fawn Gonzales Lcsw Llc NPPES

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

FAWN GONZALES LCSW LLC (NPI 1417322231) is a healthcare organization registered as a clinical in Medford, Oregon and active in the NPI registry since December 2015. The organization lists Fawn Gonzales, Owner, as its authorized official.

NPPES Registry Identity

NPI1417322231
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameFAWN GONZALES LCSW LLC
Location Address14 COTTAGE STMedford, OR 97504-7332
Mailing Address1820 W Balboa BlvdNewport Beach, CA 92663-4515 · (541) 944-7711
Phone(541) 944-7711
Organization SubpartNo
Authorized OfficialFawn GonzalesOwner · (541) 944-7711
Enumeration DateDecember 4, 2015
✔ NPI 1417322231 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in OR · 5212
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
14 COTTAGE ST, Medford, OR 97504
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fawn Gonzales Lcsw Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Fawn Gonzales Lcsw LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Fawn Gonzales, LCSW LLC
Clinical Social Worker
NPI 1295923787
2436 W COAST HWY STE 103
Newport Beach, CA 92663
(541) 944-7711
✔ PECOS✔ Accepts Medicare658 mi

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

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 Fawn Gonzales Lcsw LLC's NPI number?

The NPI number for Fawn Gonzales Lcsw LLC is 1417322231. It was assigned to this organization in the NPPES registry on December 4, 2015.

Where is Fawn Gonzales Lcsw LLC located?

Fawn Gonzales Lcsw LLC is located at 14 Cottage St, Medford, OR 97504. The listed phone number is (541) 944-7711.

What is Fawn Gonzales Lcsw LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Fawn Gonzales Lcsw LLC enrolled in Medicare?

Yes. Fawn Gonzales Lcsw LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fawn Gonzales Lcsw LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Fawn Gonzales Lcsw LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Fawn Gonzales Lcsw LLC was last updated on December 4, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.