Active NPI
Lisa G Gordon, LCSW
- Social Worker
- Springfield, VA
National Provider Identifier
1780732107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 0904003348
- Practice address
- 6800 Backlick Rd
Suite #202
Springfield, VA 22150-3070 - Phone
- (703) 921-0692
- Fax
- (703) 921-0637
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 0904003348 | VA | Primary |
Addresses
Primary practice location
6800 Backlick Rd
Suite #202
Springfield, VA 22150-3070
Mailing address
6800 Backlick Rd
Suite #202
Springfield, VA 22150-3070
Phone (703) 921-0692
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 268559 | Other | MDIPA | |
| 268559 | Other | OPTIMUM CHOICE | |
| 104300 | Other | UNITED HEALTH CARE | |
| 282455 | Other | AETNA | |
| IP282455 | Other | MAGELLAN BEHAVIORAL HEALT | |
| 126464 | Other | HEALTHNET FEDERAL SERVICE | |
| 126464 | Other | VALUE OPTIONS | |
| 182922 | Other | ANTHEM HEALTHKEEPERS | |
| 268559 | Other | ALLIANCE | |
| 268559 | Other | MAMSI | |
| 323386 | Other | MHN | |
| 1550330001 | Other | GREAT WEST HEALTHCARE | |
| 2037724 | Other | CIGNA | |
| 4294 | Other | BCBS |
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 |
|---|---|---|---|
| 0904003348 | VA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David J Wood MD Frcpc,PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Child & Adolescent Psychiatry Physician
- Springfield, VA
- NPI 1235382771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243814400000",
"number": "1780732107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 BACKLICK RD",
"address_2": "SUITE #202",
"city": "SPRINGFIELD",
"state": "VA",
"postal_code": "221503070",
"telephone_number": "703-921-0692",
"fax_number": "703-921-0637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 BACKLICK RD",
"address_2": "SUITE #202",
"city": "SPRINGFIELD",
"state": "VA",
"postal_code": "221503070",
"telephone_number": "703-921-0692",
"fax_number": "703-921-0637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "LISA",
"middle_name": "G",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2009-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "VA",
"license": "0904003348",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDIPA",
"identifier": "268559",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMUM CHOICE",
"identifier": "268559",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "104300",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "282455",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN BEHAVIORAL HEALT",
"identifier": "IP282455",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET FEDERAL SERVICE",
"identifier": "126464",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "126464",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM HEALTHKEEPERS",
"identifier": "182922",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIANCE",
"identifier": "268559",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "268559",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "323386",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST HEALTHCARE",
"identifier": "1550330001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2037724",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4294",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.