What is Sandra Gonzalez's NPI number?

The NPI number assigned to this healthcare provider is 1861156804, enumerated as a individual on October 26, 2021.

Where is the provider located?

The provider is located at 1628 E PAGE AVE MALVERN, AR 72104 and the phone number is (501) 315-3344.

What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101Y00000X.

SANDRA MARY GONZALEZ LAC - NPI 1861156804

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About Sandra Mary Gonzalez Lac NPPES

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

SANDRA MARY GONZALEZ LAC (NPI 1861156804) is an individual counselor in Malvern, Arkansas, licensed in Arkansas (A2409006) and active in the NPI registry since October 2021.

NPPES Registry Identity

NPI1861156804

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameSANDRA MARY GONZALEZCredential: LAC

Location Address1628 E PAGE AVEMalvern, AR 72104-4524

Mailing AddressPo Box 1589Benton, AR 72018-1589 · (501) 315-3344

Phone(501) 315-3344

Sole ProprietorNo

Enumeration DateOctober 26, 2021

Last NPPES UpdateMay 28, 20252 updates tracked since enumeration

NPPES CertifiedMay 28, 2025

✔ NPI 1861156804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in AR · A2409006

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

1628 E PAGE AVE, Malvern, AR 72104

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