Nechelle Gordon

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC013445 Issued in GA

Practice address

345 W Memorial Dr.
Hinesville, GA 31313-6737

Phone

(912) 707-0657

NPI assigned

Dec 8, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1457062630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 W MEMORIAL DR.",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "31313",
            "telephone_number": "912-707-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 W MEMORIAL DR.",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313136737",
            "telephone_number": "912-707-0657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Glynn St",
            "address_purpose": "LOCATION",
            "city": "Jesup",
            "state": "GA",
            "postal_code": "315457718",
            "country_code": "US",
            "telephone_number": "404-510-2836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "NECHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-08",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC007352",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC013445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nechelle.gordon@aspirehp.org",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "345 W Memorial Drive",
            "city": "Hinesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "31313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Hinesville, GA
• Providers in Hinesville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.