Jamie Lee Gordon, LPC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P0509059 Issued in AR

Practice address

920 Mitchell St
Conway, AR 72034-5148

Phone

(501) 620-0162

NPI assigned

Aug 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jamie Gordon Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Conway Counseling & Psychological Services, PLLC

  • Professional Counselor
  • Conway, AR
  • NPI 1528454139
  NPD
• Counseling Associates Inc

  • Community/Behavioral Health Agency
  • Russellville, AR
  • NPI 1649381120
  NPD
• Counseling Associates, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Heber Springs, AR
  • NPI 1144701848
  NPD
• Simple Soul Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Harrison, AR
  • NPI 1164144812
  NPD

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1649383886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 MITCHELL ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720345148",
            "telephone_number": "501-620-0162",
            "fax_number": "479-890-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MITCHELL ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720345148",
            "telephone_number": "501-620-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JAMIE",
        "middle_name": "LEE",
        "credential": "LPC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P0509059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1639558398",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1639558398",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "GORDON",
            "credential": "LPC-S",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jarrod Deshun Goodloe
• Jessica Aaron Goodman
• Shreya Gopal
• Muhammad Arqam Iqbal Goraya, MD
• Deborah Gordon, LPN
• Kaitlyn Gordon, BCABA
• Spencer Preston Gordy, DDS
• Glenda Darlene Gore, FNP-BC
• Quincy Goree, RECOVERY ASSISTANT
• Laura Gottsponer

• Professional Counselor in Conway, AR
• Providers in Conway, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.