Organization Active NPI

Gordon Counseling and Case Management PLLC

  • Clinical Social Worker
  • Holt, MI
National Provider Identifier
1528356474
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801034871 Issued in MI
Legal business name
GORDON COUNSELING AND CASE MANAGEMENT PLLC
Practice address
4463 Cricket Ridge Dr Apt 202
Holt, MI 48842-2933
Phone
(517) 281-5718
NPI assigned
Jul 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Authorized official

Name
Laurie R Gordon, LMSWNPI 1942387170
Title
Owner
Phone
(517) 281-5718

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801034871 MI Primary

Addresses

Primary practice location

4463 Cricket Ridge Dr Apt 202
Holt, MI 48842-2933

Mailing address

PO Box 43
Mason, MI 48854-0043
Phone (517) 623-6260

Other identifiers 1

IdentifierTypeStateIssuer
8008975170OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120830000318 MI Part B Supplier - Clinic/Group Practice 5294982005 Receives reassigned benefits from 5 practitioners
Practice locations: East Lansing, MI; Holt, MI; Lansing, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340582400000",
    "number": "1528356474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540043",
            "telephone_number": "517-623-6260",
            "fax_number": "517-623-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4463 CRICKET RIDGE DR APT 202",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488422933",
            "telephone_number": "517-281-5718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON COUNSELING AND CASE MANAGEMENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-13",
        "last_updated": "2012-06-25",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-281-5718",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801034871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "8008975170",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holt, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.