Active NPI
Amanda Joy Gordon, MA, LPC, CACII
- Professional Counselor
- Wheat Ridge, CO
National Provider Identifier
1376934265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0012236
- Practice address
- 10200 W 44TH Ave Ste 101
Wheat Ridge, CO 80033-2838 - Phone
- (617) 817-5050
- NPI assigned
- Feb 12, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0012236 | CO | Primary |
Addresses
Primary practice location
10200 W 44TH Ave Ste 101
Wheat Ridge, CO 80033-2838
Mailing address
10200 W 44TH Ave Ste 101
Wheat Ridge, CO 80033-2838
Phone (617) 817-5050
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0012236 | CO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568678400000",
"number": "1376934265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10200 W 44TH AVE STE 101",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800332838",
"telephone_number": "617-817-5050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10200 W 44TH AVE STE 101",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800332838",
"telephone_number": "617-817-5050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "AMANDA",
"middle_name": "JOY",
"credential": "MA, LPC, CACII",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-12",
"last_updated": "2019-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "0012236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wheat Ridge, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.