Darrin Gordon, CPRC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

M-00308 Issued in MI

Practice address

2081 W Grand Blvd
Detroit, MI 48208-1196

Phone

(313) 895-0500

NPI assigned

Apr 24, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sobriety House

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
  • NPI 1386777555
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1013571199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2081 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081196",
            "telephone_number": "313-895-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081196",
            "telephone_number": "313-895-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DARRIN",
        "name_prefix": "Mr.",
        "credential": "CPRC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "M-00308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED PEER MENTOR",
            "identifier": "M-00308",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pranav Gopalakrishnan
• Semira Vasanti Gopie, M.B.B.S.
• Sydney Lee Gordinier, FNP-C
• Carmetia Gordon, LPN
• Cole Joseph Gordon, MD
• Dasha Genay Gordon
• Emily Karen Gordon
• Jeannette Gordon, R.N.
• Julian M Gordon, PH.D.
• Kelsey Gordon, LLMSW, QIDP

• Addiction (Substance Use Disorder) Counselor in Detroit, MI
• Providers in Detroit, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.