Jose Domingo Gonzalez, LSW
Social Worker, Clinical in Youngstown, OH. Individual provider (NPI-1).
NPI number1710697321
StatusActive
Last updated in NPPESJun 17, 2025
Details
- NPI
- 1710697321
- Entity type
- Individual (NPI-1)
- Name
- Jose Domingo Gonzalez
- Credential
- LSW
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 5, 2022
- Certification date
- Jun 17, 2025
- Last updated
- Jun 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | S.2411071 | OH | Yes |
| 175T00000X | Peer Specialist | APS.003735 | OH | |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | CDCA.182780 | OH |
Practice location
725 Boardman Canfield Rd Ste C4Youngstown, OH 44512-4367
Phone 855-292-9778 · Fax 855-292-9778
Mailing address
725 Boardman Canfield Rd Ste C4Youngstown, OH 44512-4367
Phone 855-292-9778 · Fax 855-292-9778
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