Individual provider Active NPI

Destiny Deon Gordy, LPC

  • Professional Counselor
  • Longview, TX
National Provider Identifier
1851264774
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
88068 Issued in TX
Practice address
950 N 4TH St
Longview, TX 75601-5436
Phone
(903) 758-2471
Fax
(903) 234-1639
NPI assigned
Sep 26, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 88068 TX Primary

Addresses

Primary practice location

950 N 4TH St
Longview, TX 75601-5436

Mailing address

107 Woodbine PL
Longview, TX 75601-2912
Phone (903) 758-2471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20251013000114 TX Practitioner - Mental Health Counselor 0143717454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

107 Woodbine PL
Longview, TX 75601-2912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sabine Valley Regional MHMR Center Professional Current Accepting new patients
Sabine Valley Regional MHMR Center CurrentSince Sep 25, 2025 Accepting new patients

Locations

107 Woodbine Pl
Longview, TX 75601
Phone (903) 234-4226

1300 N 6th St
Longview, TX 75601
Phone (903) 232-8928

950 N 4th St
Longview, TX 75601
Phone (903) 757-1106

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1758844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1851264774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WOODBINE PL",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756012912",
            "telephone_number": "903-758-2471",
            "fax_number": "903-234-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015436",
            "telephone_number": "903-758-2471",
            "fax_number": "903-234-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDY",
        "first_name": "DESTINY",
        "middle_name": "DEON",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-26",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "88068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.