Deirdra Gordon, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P2208011 Issued in AR

Practice address

3111 S 70TH St
Fort Smith, AR 72903-5017

Phone

(479) 452-6650

NPI assigned

May 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Deirdra Shanel Pledger Former name

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Western Arkansas Counseling and Guidance Center, IncGroup PAC ID 1355326174, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Western Arkansas Counseling & Guidance Center, Inc

  dba The Guidance Center

  • Community/Behavioral Health Agency
  • Fort Smith, AR
  • NPI 1326040692
  Medicare reassignment Care Compare group NPD
• The Guidance Center - Whole Health

  dba The Guidance Center Primary Care

  • Family Medicine Physician
  • Fort Smith, AR
  • NPI 1730787037

  Mental Health

  NPD

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

{
    "created_epoch": "1589068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1912529207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 PHOENIX AVE UNIT 134",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729036054",
            "telephone_number": "479-388-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 S 70TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035017",
            "telephone_number": "479-452-6650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5410 Phoenix Avenue",
            "address_2": "Unit # 134",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "729036054",
            "country_code": "US",
            "telephone_number": "479-388-1272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DEIRDRA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-10",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A1902016",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2208011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEIRDRA",
            "last_name": "PLEDGER",
            "middle_name": "SHANEL",
            "credential": "LAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taylor Dane Goodwin, LMSW
• Nitin V Gopinath, MD
• Dolores Gordon-Williams, M.S.
• Alejandra Gordon, QBHP
• Anna K. Gordon
• Narender R Gorukanti, MD
• Gosch Therapy Services, Inc.
• Suzanne Gosch, M.S., CCC-SLP
• Deborah Kay Gossett, APN
• Sheila Rae Gossett

• Professional Counselor in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.