Callista Gordon Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CALLISTA GORDON THERAPY, LLC

Practice address

53846 Generations Dr
South Bend, IN 46635-1543

Phone

(574) 701-2799

NPI assigned

Aug 30, 2024

Organization subpart

No

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

Authorized official

Name

Callista Gordon, MSW, LCSWNPI 1508533555

Title

Owner

Phone

(574) 220-4701

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Callista Ann Gordon

  • Clinical Social Worker
  • South Bend, IN
  • NPI 1508533555
  NPD Authorized official

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

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1932933884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 DOWNEY AVE",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465443455",
            "telephone_number": "574-220-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53846 GENERATIONS DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351543",
            "telephone_number": "574-701-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALLISTA GORDON THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "CALLISTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-220-4701",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn A Calhoun, M.D.
• Mauriah J Calhoun, MSW
• Vincent Calhoun, PA-C
• Megan Calkins, FNP-BC
• Katharine Aileen Callaghan, MD
• Pamela Calvano, L. M. F. T.
• Richmond Edward Calvin, LCSW LMFT LHMC
• Lisa Cammett, O.D.
• Julisa Cynthia Campbell, RBT
• Heather A Campion, M.D.

• Clinical Social Worker in South Bend, IN
• Providers in South Bend, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.