Deja Keanna Gordon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904013488 Issued in VA

Practice address

3388 Princess Anne Rd Ste 2001
Virginia Beach, VA 23456-2612

Phone

(757) 507-7270

NPI assigned

Jan 6, 2022

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Chesterfield Family Guidance Center

  • Clinical Psychologist
  • Richmond, VA
  • NPI 1225192909
  NPD
• Sentara Medical Group

  • Psychologist
  • Virginia Beach, VA
  • NPI 1255096442
  NPD
• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  NPD

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1811658487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3388 PRINCESS ANNE RD STE 2001",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234562612",
            "telephone_number": "757-507-7270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3388 PRINCESS ANNE RD STE 2001",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234562612",
            "telephone_number": "757-507-7270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Newtown Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234621265",
            "country_code": "US",
            "telephone_number": "757-974-1469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DEJA",
        "middle_name": "KEANNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vona Goodpaster
• Jessica Carolyn Goodrich
• John Robert Goodwin
• Kelsie Goodwin, DO
• Keegan Gopaul
• Erin Suzanne Gordon, PT
• Kevin Bruce Gordon
• Kiersten Maleah Gordon
• Lauren M Gordon, M.S., CCC-SLP
• Madelyn Gordon

• Clinical Social Worker in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.