Individual provider Active NPI

Lenty Gordon, M.A., C.A.G.S, LMHC

  • Mental Health Counselor
  • North Providence, RI
National Provider Identifier
1609359074
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHC01218 Issued in RI
Practice address
40 Marconi St
North Providence, RI 02904-3901
Phone
(401) 556-2688
NPI assigned
Sep 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X RI
Mental Health Counselor 101YM0800X MHC01218 RI Primary

Addresses

Primary practice location

40 Marconi St
North Providence, RI 02904-3901

Mailing address

40 Marconi St
North Providence, RI 02904-3901
Phone (401) 556-2688

Other practice location 1

345 Blackstone Blvd
Providence, RI 02906-4800
Phone (401) 455-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240206002195 RI Practitioner - Mental Health Counselor 6507209624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Jan 1, 2024 Accepting new patients
Affinity Physicians LLC. Current Accepting new patients

Locations

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1609359074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MARCONI ST",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029043901",
            "telephone_number": "401-556-2688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MARCONI ST",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029043901",
            "telephone_number": "401-556-2688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Blackstone Blvd",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029064800",
            "country_code": "US",
            "telephone_number": "401-455-6200",
            "fax_number": "401-455-6689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "LENTY",
        "credential": "M.A., C.A.G.S, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "RI",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC01218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Providence, RI

Sources for this page

Verify at the official NPI Registry.