Glenn Robert Gordon, LADC, MHRT-CSP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LC8262 Issued in ME

Practice address

150 Congress St
Rumford, ME 04276-2035

Phone

(207) 357-1751

NPI assigned

Apr 3, 2024

Last updated

Apr 3, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Community Concepts Incorporated

  • Community/Behavioral Health Agency
  • Rumford, ME
  • NPI 1962591230
  NPD
• Community Concepts, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Rumford, ME
  • NPI 1275774739
  NPD (past)

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1063264083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CONGRESS ST",
            "city": "RUMFORD",
            "state": "ME",
            "postal_code": "042762035",
            "telephone_number": "207-357-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CONGRESS ST",
            "city": "RUMFORD",
            "state": "ME",
            "postal_code": "042762035",
            "telephone_number": "207-357-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GLENN",
        "middle_name": "ROBERT",
        "credential": "LADC, MHRT-CSP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC8262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Fraser
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• Becky Ann Hall, RNFA
• Rachael Hall, LD
• Donna Hamilton, LPN
• Debora A Hamlin

• Addiction (Substance Use Disorder) Counselor in Rumford, ME
• Providers in Rumford, ME by specialty
• Addiction (Substance Use Disorder) Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.