Jasmine Tierra Gordon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C013048 Issued in NC

Practice address

709 Cider Mill Way
Zebulon, NC 27597-3311

Phone

(984) 289-8127

NPI assigned

Feb 15, 2018

Sex

Female

Sole proprietor

Yes

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.

• Gordonway Solutions

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Zebulon, NC
  • NPI 1144007899
  NPD Authorized official
• Realway Solutions PLLC

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1457105017

  Clinical

  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 15, 2023.

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1891295960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 CIDER MILL WAY",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "275973311",
            "telephone_number": "984-289-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 CIDER MILL WAY",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "275973311",
            "telephone_number": "984-289-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JASMINE",
        "middle_name": "TIERRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Elizabeth Gatling, BCBA
• Pazhayidathe K George, MD PHD FACP
• Brandi Gibson, M.ED., LCMHC, NCC
• Gill'S Transportation, LLC
• Goodlife Wellness Group PLLC
• Gordonway Solutions
• Kimberly Griswold
• Regina Elizabeth Groesser, PNP
• Growing Child Office Meds Inc
• Growing Child Pediatrics

• All providers in Zebulon, NC
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.