Heather E Gordon, LMHC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

32755 Issued in NY

Practice address

7210 112TH St Ofc B
Forest Hills, NY 11375-5467

Phone

(833) 369-1144

Fax

(682) 207-1826

NPI assigned

Jan 26, 2017

Last updated

Jan 16, 2024By 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

Other names 1

• Heather Eisenberg Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Be a Version of Yourself Mental Health Counseling, PLLC

  dba BAVOY Mental Health Counseling, PLLC

  • Mental Health Counselor
  • Middletown, NY
  • NPI 1366097438
  NPD (past)

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1689111775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LEYLINE EDUCATION DBA GEEK THERAPEUTICS",
            "address_2": "7801 OAKMONT BLVD STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324242",
            "telephone_number": "833-369-1144",
            "fax_number": "682-207-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 112TH ST OFC B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755467",
            "telephone_number": "833-369-1144",
            "fax_number": "682-207-1826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Leyline Education dba Geek Therapeutics",
            "address_2": "7801 Oakmont Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761324242",
            "country_code": "US",
            "telephone_number": "833-369-1144",
            "fax_number": "682-207-1826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "HEATHER",
        "middle_name": "E",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-26",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "32755",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "93631",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "EISENBERG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ronnie Stephanie Goodfriend, EDD
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• Carole Goodsmith, L.C.S.W.
• Jessica Goodwin, MHC
• Luba Gorsky
• Karoline Gostl, LAC.
• Vladimir Gotlieb, MD
• Jay Galbraith Gould Jr., PH D
• Irene Goykhberg, M.A., CCC-SLP

• Addiction (Substance Use Disorder) Counselor in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.