Individual provider Active NPI

Lauren Stephanie Gordon, MSW, LSCW

  • Clinical Social Worker
  • Germantown, NY
National Provider Identifier
1952428500
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R026297-1 Issued in NY
Practice address
110 Half Circle Rd Ext
Germantown, NY 12526-5233
Phone
(917) 656-6047
NPI assigned
Mar 26, 2007
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R026297-1 NY Primary

Addresses

Primary practice location

110 Half Circle Rd Ext
Germantown, NY 12526-5233

Mailing address

110 Half Circle Rd Ext
Germantown, NY 12526-5233
Phone (917) 656-6047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20161012001040 NY Practitioner - Clinical Social Worker 3173811833 Practice locations: Germantown, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Stony Brook, School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

110 Half Circle Rd Ext
Germantown, NY 12526-5233
Phone (917) 656-6047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R026297-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Service Program for Older People PastSince Aug 16, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1952428500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HALF CIRCLE RD EXT",
            "city": "GERMANTOWN",
            "state": "NY",
            "postal_code": "125265233",
            "telephone_number": "917-656-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HALF CIRCLE RD EXT",
            "city": "GERMANTOWN",
            "state": "NY",
            "postal_code": "125265233",
            "telephone_number": "917-656-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "LAUREN",
        "middle_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "MSW, LSCW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R026297-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, NY

Sources for this page

Verify at the official NPI Registry.