Individual provider Active NPI

Devra Sara Gordon, LCSW

  • Clinical Social Worker
  • Arlington, VA
National Provider Identifier
1326620303
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904012837 Issued in VA
Practice address
801 N Quincy St Ste 620
Arlington, VA 22203-1729
Phone
(703) 812-4642
NPI assigned
Apr 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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 0904012837 VA Primary

Addresses

Primary practice location

801 N Quincy St Ste 620
Arlington, VA 22203-1729

Mailing address

13563 Point Pleasant Dr
Chantilly, VA 20151-2442
Phone (618) 558-4326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20221101002249 DC Practitioner - Clinical Social Worker 2668849803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Goyal Medpsych IncGroup PAC ID 3375978984, 25 clinicians

Practice addresses (Care Compare)

2110 Gallows Rd
Suite D
Vienna, VA 22182-3962
Phone (703) 592-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Goyal Medpsych Inc CurrentSince Oct 1, 2022 Accepting new patients
Neta, Inc. CurrentSince May 16, 2021 Accepting new patients

Locations

801 N Quincy St
Ste 620
Arlington, VA 22203
Phone (703) 412-4642

2110 Gallows Rd
Ste D
Vienna, VA 22182
Phone (703) 592-4600

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1326620303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13563 POINT PLEASANT DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512442",
            "telephone_number": "618-558-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N QUINCY ST STE 620",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031729",
            "telephone_number": "703-812-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DEVRA",
        "middle_name": "SARA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.