Individual provider Active NPI

Dawn Renee Gordon, LPCC, LICDC

  • Professional Counselor
  • Columbus, OH
National Provider Identifier
1043743149
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.1600039 Issued in OH
Practice address
1800 Zollinger Rd FL 5
Columbus, OH 43221-2800
Phone
(614) 293-5123
Fax
(614) 293-4980
NPI assigned
Apr 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.161376 OH
Professional Counselor 101YP2500X E.1600039 OH Primary

Addresses

Primary practice location

1800 Zollinger Rd FL 5
Columbus, OH 43221-2800

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-5123

Other practice location 1

2050 Kenny Rd
Suite 3300
Columbus, OH 43221-3502
Phone (614) 685-6532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111000948 OH Practitioner - Mental Health Counselor 5698126977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu General Internal Medicine LLCGroup PAC ID 7517103955, 270 clinicians

Practice addresses (Care Compare)

1800 Zollinger Rd
Columbus, OH 43221-2849
Phone (614) 293-7417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICDC.161376OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Osu General Internal Medicine LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

2050 Kenny Rd
Columbus, OH 43221
Phone (614) 293-8054

2050 Kenny Rd
Ste 3300
Columbus, OH 43221
Phone (614) 366-9211

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

1800 Zollinger Rd
Fl 5
Upper Arlington, OH 43221
Phone (614) 293-2700

1800 Zollinger Rd
Upper Arlington, OH 43221
Phone (614) 293-2130

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1043743149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-5123",
            "fax_number": "614-293-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ZOLLINGER RD FL 5",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432212800",
            "telephone_number": "614-293-5123",
            "fax_number": "614-293-4980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2050 Kenny Rd",
            "address_2": "Suite 3300",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432213502",
            "country_code": "US",
            "telephone_number": "614-685-6532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DAWN",
        "middle_name": "RENEE",
        "credential": "LPCC, LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161376",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1600039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.