Active NPI
Judy Ellen Gordon, L.M.H.C.
- Mental Health Counselor
- Ellicott City, MD
National Provider Identifier
1013006410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 000294
- Practice address
- 5006 Dorsey Hall Dr
C-2
Ellicott City, MD 21042-7737 - Phone
- (443) 604-2741
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 000294 | NY | Primary |
Addresses
Primary practice location
5006 Dorsey Hall Dr
C-2
Ellicott City, MD 21042-7737
Mailing address
5006 Dorsey Hall Dr
C-2
Ellicott City, MD 21042-7737
Phone (443) 604-2741
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000294 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462924800000",
"number": "1013006410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5006 DORSEY HALL DR",
"address_2": "C-2",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210427737",
"telephone_number": "443-604-2741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5006 DORSEY HALL DR",
"address_2": "C-2",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210427737",
"telephone_number": "443-604-2741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "JUDY",
"middle_name": "ELLEN",
"name_prefix": "Ms.",
"credential": "L.M.H.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2016-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "000294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.