Steven Gordon, LCSWR

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

049123R Issued in NY

Practice address

646 Commack Rd
Commack, NY 11725-5426

Phone

(646) 402-5363

Fax

(631) 543-8573

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 28, 2020 through Feb 29, 2028

Medicare enrollment (NPD)

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.

• Safe Horizon Inc

  • Clinical Social Worker
  • Brooklyn, NY
  • NPI 1063441848
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1225045511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 113TH ST",
            "address_2": "APT 2 I",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755635",
            "telephone_number": "718-575-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 COMMACK RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255426",
            "telephone_number": "646-402-5363",
            "fax_number": "631-543-8573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "STEVEN",
        "name_prefix": "Mr.",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2022-03-08",
        "certification_date": "2021-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R049123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "049123R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Amy Goldstein, MS SPECIAL ED.
• Ivette G Gomez, RN
• Teresa M Goncalves, ANP-C
• Melissa Gordillo-Gomez, MHC-LP
• Donna Lee Gordon, CPHT
• Julie Beth Gorowitz, LAC.
• Richard W Gotlib, MD
• Shannon M Graepel, MHC-LP
• Scott Michael Gralla, L. AC.
• Tania C Gransasso

• Clinical Social Worker in Commack, NY
• Providers in Commack, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.