Individual provider Active NPI

Craig A Gordon II, LPC, NCC

  • Mental Health Counselor
  • Arlington, VA
National Provider Identifier
1366004053
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701007484 Issued in VA
Practice address
2001 Jefferson Davis Hwy Ste 800
Arlington, VA 22202-3603
Phone
(704) 771-5679
NPI assigned
Jul 2, 2019
Last updated
Jul 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0701007484 VA Primary

Addresses

Primary practice location

2001 Jefferson Davis Hwy Ste 800
Arlington, VA 22202-3603

Mailing address

315 N Quebec St Apt 1
Arlington, VA 22203-3415
Phone (704) 771-5679

Other practice location 1

6563 Edsall Rd
Springfield, VA 22151-4414
Phone (703) 354-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0701007484VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Multicultural Clinical Center Past Accepting new patients
Multicultural Clinical Center Past Accepting new patients

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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1366004053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N QUEBEC ST APT 1",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222033415",
            "telephone_number": "704-771-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 JEFFERSON DAVIS HWY STE 800",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222023603",
            "telephone_number": "704-771-5679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6563 Edsall Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VA",
            "postal_code": "221514414",
            "country_code": "US",
            "telephone_number": "703-354-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CRAIG",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701007484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.