Vanessa Gourdine, APN-C, PSYD

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ00080100 Issued in NJ

Practice address

83 Summit Ave
Hackensack, NJ 07601-1262

Phone

(201) 488-6678

Fax

(201) 342-4346

NPI assigned

Sep 22, 2006

Last updated

Sep 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 9

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Life Strategies

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hackensack, NJ
  • NPI 1902068950
  Authorized official Same address or phone
• Specialized Therapy Associates

  • Adult Mental Health Clinic/Center
  • Hackensack, NJ
  • NPI 1407953896
  NPD (past) Authorized official
• Specialized Therapy Associates LLC

  • Nurse Practitioner
  • Hackensack, NJ
  • NPI 1417293101
  Authorized official Same address or phone
• Specialized Therapy Associates LLC

  • Counselor
  • Hackensack, NJ
  • NPI 1467798157
  Authorized official Same address or phone
• Specialized Therapy Associates LLC

  • Social Worker
  • Hackensack, NJ
  • NPI 1548506231
  Authorized official Same address or phone
• Specialized Therapy Associates LLC

  • Psychologist
  • Hackensack, NJ
  • NPI 1851637557
  Authorized official Same address or phone

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1205936093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074170746",
            "telephone_number": "201-488-6678",
            "fax_number": "201-342-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011262",
            "telephone_number": "201-488-6678",
            "fax_number": "201-342-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURDINE",
        "first_name": "VANESSA",
        "name_prefix": "Dr.",
        "credential": "APN-C, PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00080100",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00080100",
            "primary": true
        },
        {
            "code": "364SP0810X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Family",
            "state": "NJ",
            "license": "26NJ00080100",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00263500",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "35SI00263500",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00263500",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NJ",
            "license": "35SI00263500",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "NJ",
            "license": "35SI00263500",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NJ",
            "license": "35SIO00563500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Goodman, APN
• Manuel Barry Gordon
• Jessica Gorgo, D.O.
• Joselina Goris-Hernandez, APN
• Deborah Anne Marie Goss, MD
• Aparna Govindan
• Niketa Vinod Govindani, M.D.
• Andre H Goy, MD
• Grace Medical Association Corporation
• Grace Total Homecare Services LLC.

• Psychiatric/Mental Health Nurse Practitioner in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.