Callie Gordon Marino, LPCA, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A9336 Issued in NC

Practice address

208 E Bessemer Ave
Greensboro, NC 27401-6320

Phone

(336) 542-2076

Fax

(336) 272-1182

NPI assigned

Mar 28, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Callie Elizabeth Gordon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1417223991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 E BESSEMER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016320",
            "telephone_number": "336-542-2076",
            "fax_number": "336-272-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E BESSEMER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016320",
            "telephone_number": "336-542-2076",
            "fax_number": "336-272-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "CALLIE",
        "middle_name": "GORDON",
        "credential": "LPCA, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A9336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CALLIE",
            "last_name": "GORDON",
            "middle_name": "ELIZABETH",
            "credential": "LPCA, NCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.