Individual provider Active NPI

Steven Gordon

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1083106033
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P10425 Issued in NY
Practice address
207 Prospect Park West
Suite #1
Brooklyn, NY 11215
Phone
(917) 877-0218
NPI assigned
Jun 5, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P10425 NY Primary

Addresses

Primary practice location

207 Prospect Park West
Suite #1
Brooklyn, NY 11215

Mailing address

207 Prospect Park West
Suite #1
Brooklyn, NY 11215
Phone (917) 877-0218

Other practice location 1

207 Prospect Park West
Suite #1
Brooklyn, NY 11215
Phone (917) 877-0218

Other practice location 2

1664 E 14th St
Brooklyn, NY 11229
Phone (929) 273-7601 ext. 412

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

State licenses

LicenseStateTypeSpecialty
P10425NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1083106033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 PROSPECT PARK WEST",
            "address_2": "SUITE #1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215",
            "telephone_number": "917-877-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 PROSPECT PARK WEST",
            "address_2": "SUITE #1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215",
            "telephone_number": "917-877-0218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 Prospect Park West",
            "address_2": "Suite #1",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11215",
            "country_code": "US",
            "telephone_number": "917-877-0218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1664 E 14th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11229",
            "country_code": "US",
            "telephone_number": "929-273-7601 x412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "STEVEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P10425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.