Individual provider Active NPI

Jillian Arrosa Gordon, LCSW

  • Clinical Social Worker
  • Kingston, NY
National Provider Identifier
1275627291
Registry record updated May 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
074261 Issued in NY
Practice address
159 Green St
Ste 23
Kingston, NY 12401-3736
Phone
(718) 993-1400
Fax
(718) 993-0647
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 074261 NY Primary

Addresses

Primary practice location

159 Green St
Ste 23
Kingston, NY 12401-3736

Mailing address

PO Box 312
Bearsville, NY 12409-0312
Phone (917) 573-5072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120413000059 NY Practitioner - Clinical Social Worker 4284895582 Practice locations: Kingston, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Columbia University College of Physicians and Surgeons, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

159 Green St
Suite 23
Kingston, NY 12401-3736
Phone (917) 573-5072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Counseling LCSW, PLLC Clinical PastSince Mar 1, 2012 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494979200000",
    "number": "1275627291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 312",
            "city": "BEARSVILLE",
            "state": "NY",
            "postal_code": "124090312",
            "telephone_number": "917-573-5072",
            "fax_number": "917-573-5072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 GREEN ST",
            "address_2": "STE 23",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013736",
            "telephone_number": "718-993-1400",
            "fax_number": "718-993-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JILLIAN",
        "middle_name": "ARROSA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2017-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.