Mona Gordon

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC014638 Issued in GA

Practice address

3643 Walton Way Ext BLDG 4
Augusta, GA 30909-6677

Phone

(706) 364-1404

NPI assigned

Jun 10, 2016

Last updated

Apr 21, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mona.gordon.1@25899.direct.athenahealth.com

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.

• Psychiatric Professionals of Georgia, LLC

  • Psychiatry Physician
  • Suwanee, GA
  • NPI 1396277968
  Medicare reassignment NPD

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713657600000",
    "number": "1790134674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3643 WALTON WAY EXT BLDG 4",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096677",
            "telephone_number": "706-364-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 WALTON WAY EXT BLDG 4",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096677",
            "telephone_number": "706-364-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MONA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2024-04-21",
        "certification_date": "2024-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC014638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon Highway Dental Group, LLC (Augusta Smiles Youth Dentistry)
• Chawnette Washington Gordon, CLC
• Jamie Gordon, LPC
• Mackenzie Gordon, CTRS
• Megan Tucker Gordon, OTR/L
• Tito Terrell Gordon, LPC
• Austin E Gore, RPH
• Johnathan Richard Gore, MD
• Jane Anne Gorham, DO
• Ben-Patrick Martinez Gorion, DO

• Professional Counselor in Augusta, GA
• Providers in Augusta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.