Kiera Gordon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW18484 Issued in FL

Practice address

4361 Thornwood Ave
Matteson, IL 60443-1269

Phone

(708) 825-7697

NPI assigned

Jun 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1164099024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4361 THORNWOOD AVE",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604431269",
            "telephone_number": "708-825-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 THORNWOOD AVE",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604431269",
            "telephone_number": "708-825-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KIERA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW18484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "DesktopsLaptops",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4361 Thornwood Ave",
            "city": "Matteson",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604431269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Reaelma N/a Gipson, PMHNP
• Andrea Glenn
• Courtney Alyssa Gogins
• Gena Goldman
• Dionna Gordon
• Suzanne Marie Gorman, PHARMD
• Gotham Lab Services LLC
• Gracetouch Home Care Services
• Grand Prairie Services
• Greater Works Reintegration Outreach Center, Inc.

• Clinical Social Worker in Matteson, IL
• Providers in Matteson, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.