Lisa Gordon, MSW, LCSW-C, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18124 Issued in MD

Practice address

9500 Arena Dr Ste 460C
Largo, MD 20774-3755

Phone

(240) 473-2313

NPI assigned

Jan 11, 2014

Last updated

Mar 17, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anew Therapeutic Services LLC

  • Community/Behavioral Health Agency
  • Largo, MD
  • NPI 1457864290
  NPD Authorized official

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

{
    "created_epoch": "1389398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1639591548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 WESTWAY APT 102",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207701991",
            "telephone_number": "240-473-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 ARENA DR STE 460C",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207743755",
            "telephone_number": "240-473-2313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7821 Mandan Rd",
            "address_purpose": "LOCATION",
            "city": "Greenbelt",
            "state": "MD",
            "postal_code": "207702143",
            "country_code": "US",
            "telephone_number": "617-954-5045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "LISA",
        "credential": "MSW, LCSW-C, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50078379",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "18124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teddy Gould Goetz, MD, MS
• Harvey R Gold, MD
• Good Health Nutrition Services LLC
• Angela Goodwin, PHARMD
• David A Gooray, MD
• Natalie Gospodinoff, MD
• Jene Gould, LCSW-C, CCTP
• Catherine E. Graham, PSY.D.
• Virgil Lee Graham, MD
• Lorette Gray, LCSW-C

• Clinical Social Worker in Largo, MD
• Providers in Largo, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.