Individual provider Active NPI

Gloria J. Gordy, GLORIA GORDY

  • Addiction (Substance Use Disorder) Counselor
  • Gloucester, VA
National Provider Identifier
1457647174
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
0024182052 Issued in VA
Practice address
9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162
Phone
(804) 695-8120
Fax
(804) 695-8122
NPI assigned
Jun 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X 0024182052 VA
Registered Nurse 163W00000X 0001120029 VA
Clinical Nurse Specialist 364S00000X 0024182052 VA
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 0024182052 VA
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist 364SP0810X 0024182052 VA
Addiction (Substance Use Disorder) Counselor 101YA0400X 0024182052 VA Primary

Addresses

Primary practice location

9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162

Mailing address

113 Ellery St
Yorktown, VA 23692-3194
Phone (757) 375-9026

Other names 1

  • Gloria J. Gordy Professional name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001120029VAMDRegistered Nurse
0024182052VAMDChild & Family Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1457647174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 ELLERY ST",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236923194",
            "telephone_number": "757-375-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614162",
            "telephone_number": "804-695-8120",
            "fax_number": "804-695-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDY",
        "first_name": "GLORIA",
        "middle_name": "J.",
        "credential": "GLORIA GORDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "VA",
            "license": "0024182052",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001120029",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "VA",
            "license": "0024182052",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "VA",
            "license": "0024182052",
            "primary": false
        },
        {
            "code": "364SP0810X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Family",
            "state": "VA",
            "license": "0024182052",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0024182052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "GORDY",
            "middle_name": "J.",
            "credential": "GLORIA GORDY",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Gloucester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.