Active NPI
Kristin Gordon
- Clinical Social Worker
- Hudson Falls, NY
National Provider Identifier
1760186852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 095130
- Practice address
- 47 Vaughn Rd
Hudson Falls, NY 12839-1219 - Phone
- (518) 681-4468
- NPI assigned
- Mar 30, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 095130 | NY | Primary |
Addresses
Primary practice location
47 Vaughn Rd
Hudson Falls, NY 12839-1219
Mailing address
PO Box 710
Hudson Falls, NY 12839-0710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 095130 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680134400000",
"number": "1760186852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 710",
"city": "HUDSON FALLS",
"state": "NY",
"postal_code": "128390710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 VAUGHN RD",
"city": "HUDSON FALLS",
"state": "NY",
"postal_code": "128391219",
"telephone_number": "518-681-4468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "KRISTIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-30",
"last_updated": "2023-03-30",
"certification_date": "2023-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "095130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hudson Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.