Active NPI
Constance Lee Gordon, LISW-SUPV
- Clinical Social Worker
- Chillicothe, OH
National Provider Identifier
1508095688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.88887 - S
- Practice address
- 17273 State Route 104
Chillicothe, OH 45601-9718 - Phone
- (740) 773-1141
- Fax
- (740) 772-7088
- NPI assigned
- Jul 9, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I.88887 - S | OH | Primary |
Addresses
Primary practice location
17273 State Route 104
Chillicothe, OH 45601-9718
Mailing address
17273 State Route 104
Chillicothe, OH 45601-9718
Phone (740) 773-1141
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
| License | State | Type | Specialty |
|---|---|---|---|
| I.88887 - S | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aware Resources, Inc. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Munroe Falls, OH
- NPI 1518070630
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247097600000",
"number": "1508095688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17273 STATE ROUTE 104",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456019718",
"telephone_number": "740-773-1141",
"fax_number": "740-772-7088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17273 STATE ROUTE 104",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456019718",
"telephone_number": "740-773-1141",
"fax_number": "740-772-7088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "CONSTANCE",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "LISW-SUPV",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-09",
"last_updated": "2009-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.88887 - S",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chillicothe, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.