Individual provider Active NPI

Ruth D Gordon, MA, MSW, LICSW

  • Clinical Social Worker
  • Naples, FL
National Provider Identifier
1831273572
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW6595 Issued in FL
Practice address
1930 Imperial Golf Course Blvd
Naples, FL 34110-1079
Phone
(239) 692-8060
Fax
(239) 692-8050
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW6595 FL Primary
Clinical Social Worker 1041C0700X 1021501 MA

Addresses

Primary practice location

1930 Imperial Golf Course Blvd
Naples, FL 34110-1079

Mailing address

1930 Imperial Golf Course Blvd
Naples, FL 34110-1079
Phone (239) 692-8060

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SW6595FLMDClinical Social Worker
1021501MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1831273572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 IMPERIAL GOLF COURSE BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101079",
            "telephone_number": "239-692-8060",
            "fax_number": "239-692-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 IMPERIAL GOLF COURSE BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101079",
            "telephone_number": "239-692-8060",
            "fax_number": "239-692-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "RUTH",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "MA, MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6595",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1021501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; 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.