Gonzalez, Autumn Ashley

Gonzalez, Autumn Ashley is an individual health care provider with primary practice located at 4101 John Deere Rd , Moline IL 61265-9951. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Gonzalez, Autumn Ashley can be contacted via phone (309) 762-5433.

Contact Information

Primary practice address
4101 John Deere Rd Moline IL 61265-9951
Phone: (309) 762-5433
Fax: (309) 762-4481
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 36433 Illinois
Behavioral Health & Social Service Providers / Professional 101YP2500X 108785 Iowa
Behavioral Health & Social Service Providers / Professional 101YP2500X 180.013574 Illinois

Profile Details

NPI number 1699339978
LBN Legal business name Gonzalez, Autumn Ashley
Credentials LCPC, LMHP, CAADC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2019
Last updated Jun 27th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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