Jason Gordon, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00488100 Issued in NJ

Practice address

179 Davis Ave
Piscataway, NJ 08854-2467

Phone

(908) 451-2550

NPI assigned

May 20, 2014

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1114339553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 DAVIS AVE",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088542467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 DAVIS AVE",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088542467",
            "telephone_number": "908-451-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JASON",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-20",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00488100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Piscataway, NJ
• Providers in Piscataway, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.