Candace Rachell Gordon, BCABA

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

C-125 Issued in LA

Practice address

11606 Southfork Ave Ste 100
Baton Rouge, LA 70816-5235

Phone

(225) 831-9583

NPI assigned

Feb 28, 2018

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

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": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1215439872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 RANGE AVE STE 110-162",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707264820",
            "telephone_number": "225-301-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11606 SOUTHFORK AVE STE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708165235",
            "telephone_number": "225-831-9583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14025 Colt Dr",
            "address_purpose": "LOCATION",
            "city": "Denham Springs",
            "state": "LA",
            "postal_code": "707267360",
            "country_code": "US",
            "telephone_number": "225-301-0588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CANDACE",
        "middle_name": "RACHELL",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "LA",
            "license": "C-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goodwood Medical Rehab Center, LLC
• Goodwood Primary Care Clinic, LLC
• Gopinath Gopalam, MS
• Kasey Scallan Gora, PA
• Gordon & Gordon Consulting LLC
• Cheryl G Gordon, M. ED., MHP
• Christa Culpepper Gordon, PA-C
• Debra H Gordon, M:ED
• Garrick Gordon Sr.
• Kiyuana A Gordon

• Assistant Behavior Analyst in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Assistant Behavior Analyst in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.