Claire Gordijn, MS, RMHCI

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC014318 Issued in GA

Practice address

111 W Magnolia Ave
Longwood, FL 32750-4130

Phone

(407) 215-0095

NPI assigned

Jun 22, 2020

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1699391029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W MAGNOLIA AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504130",
            "telephone_number": "407-215-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W MAGNOLIA AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504130",
            "telephone_number": "407-215-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDIJN",
        "first_name": "CLAIRE",
        "credential": "MS, RMHCI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "IMH17550",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC014318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMPOWER",
            "identifier": "IMH17550",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Outlook",
            "affiliation": "N",
            "address_1": "3426 Saddle Blvd",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328263118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Longwood, FL
• Providers in Longwood, FL by specialty
• Professional Counselor in Florida

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