Organization Active NPI

Patricia E. Gordon, LCSW-R, LLC

  • Clinical Social Worker
  • Danbury, CT
National Provider Identifier
1043687825
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PATRICIA E. GORDON, LCSW-R, LLC
Practice address
68 Virginia Ave
#7
Danbury, CT 06810-5764
Phone
(203) 733-8033
Fax
(203) 612-2337
NPI assigned
Aug 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Authorized official

Name
Patricia E. Gordon, LCSW-R
Title
Psychotherapist
Phone
(203) 733-8033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

68 Virginia Ave
#7
Danbury, CT 06810-5764

Mailing address

68 Virginia Ave
#7
Danbury, CT 06810-5764
Phone (203) 733-8033

Other identifiers 1

IdentifierTypeStateIssuer
D30069939OtherCTMEDICARE PTAN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1043687825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 VIRGINIA AVE",
            "address_2": "#7",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105764",
            "telephone_number": "203-733-8033",
            "fax_number": "203-612-2337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 VIRGINIA AVE",
            "address_2": "#7",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105764",
            "telephone_number": "203-733-8033",
            "fax_number": "203-612-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA E. GORDON, LCSW-R, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "203-733-8033",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "D30069939",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.