Provider Demographics
NPI:1679776215
Name:GONZALES, MILAGROS MARIA (LCSW)
Entity type:Individual
Prefix:MS
First Name:MILAGROS
Middle Name:MARIA
Last Name:GONZALES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1723 CROSBY AVE # 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4901
Mailing Address - Country:US
Mailing Address - Phone:646-391-7052
Mailing Address - Fax:347-503-0991
Practice Address - Street 1:847 CASTLE HILL AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-1337
Practice Address - Country:US
Practice Address - Phone:646-391-7052
Practice Address - Fax:347-503-0991
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0697191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical