Active NPI
Lara Suzanne Gordon, PHD
- Psychologist
- Clifton Park, NY
National Provider Identifier
1033909932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 027222
- Practice address
- 6 Chelsea PL Ste 202
Clifton Park, NY 12065-3236 - Phone
- (518) 878-3184
- NPI assigned
- May 12, 2025
- Last updated
- May 12, 2025
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 027222 | NY | Primary |
Addresses
Primary practice location
6 Chelsea PL Ste 202
Clifton Park, NY 12065-3236
Mailing address
6 Chelsea PL Ste 202
Clifton Park, NY 12065-3236
Phone (518) 878-3184
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027222 | NY | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747008000000",
"number": "1033909932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 CHELSEA PL STE 202",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "120653236",
"telephone_number": "518-878-3184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 CHELSEA PL STE 202",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "120653236",
"telephone_number": "518-878-3184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "LARA",
"middle_name": "SUZANNE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-12",
"last_updated": "2025-05-12",
"certification_date": "2025-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "027222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.