Krista Marie Gordon, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC14659 Issued in MD

Practice address

18714 North Village Shopping Center
Hagerstown, MD 21742

Phone

(301) 733-0331

NPI assigned

Mar 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703980800000",
    "number": "1023766052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18714 NORTH VILLAGE SHOPPING CENTER",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21742",
            "telephone_number": "301-733-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18714 NORTH VILLAGE SHOPPING CENTER",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21742",
            "telephone_number": "301-733-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KRISTA",
        "middle_name": "MARIE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-18",
        "last_updated": "2023-12-31",
        "certification_date": "2023-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP12298",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC14659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eryn Gordon, PHARMD, RPH
• Nina J. Gordon, M.D.
• Stacey Gordon, R.PH.
• Jessica Gorman, LGPC
• Leeann Gorman, LMSW
• Grace Venture Inc

• Professional Counselor in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.