JASON GORDON (NPI# 1174934764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174934764 |
| Entity Type | Individual |
| Full Name | JASON GORDON |
| Credential | CLINICAL SOCIAL WORK |
| Practice Address |
1st Street Holloman Afb Holloman Afb NM 88330 |
| Mailing Address |
Po Box 10 La Mesa CA 91944-0010 |
| Practice Telephone | 5755720000 |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2015-02-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588121776 | Jason Gordon | Acupuncturist | 205 E Rivo Alto Dr, Miami Beach, FL 33139-1247 | 2019-02-25 |
| 1114339553 | Jason Gordon | Counselor | 179 Davis Ave, Piscataway, NJ 08854-2467 | 2014-05-20 |
| 1326240458 | Jason R Gordon | Dentist | 724 Pelham Pkwy S, Bronx, NY 10462-1029 | 2007-06-01 |
| 1801455597 | Jason M Gordon | Dentist | 1963 S 1200 E Ste 103, Salt Lake City, UT 84105-3523 | 2019-06-06 |
| 1033641493 | Jason Gordon | Student in an Organized Health Care Education/Training Program | 108 E 96th St, Apt 5a, New York, NY 10128-6217 | 2017-04-03 |
| 1568902278 | Jason Gordon | Physical Therapist | 321 N Larchmont Blvd Ste 825, Los Angeles, CA 90004-6400 | 2017-02-28 |
| 1790132959 | Jason R Gordon | Emergency Medicine | 7435 W Talcott Ave, Chicago, IL 60631-3707 | 2016-05-18 |
| 1497915227 | Jason Gordon | Emergency Medicine | 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547-2538 | 2008-06-16 |
| 1720245160 | Jason Gordon | Emergency Medicine | 3950 Austell Rd, Austell, GA 30106-1121 | 2008-05-22 |
| 1518024769 | Jason Gordon | Chiropractor | 162 W 56th St, Suite 205, New York, NY 10019-3831 | 2007-01-03 |
| Street Address |
1ST STREET HOLLOMAN AFB |
| City | HOLLOMAN AFB |
| State | NM |
| Zip Code | 88330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598312084 | Zachary James Smith | Pharmacist | 49th Medical Group 280 First Street, Holloman Afb, NM 88330 | 2019-08-20 |
| 1346776804 | Maxilea Isom | Behavior Technician | 2079 Eglin Ave Apt A, Holloman, Afb, NM 88330 | 2017-05-03 |
| 1932558665 | Courtney Davis | Day Training/Habilitation Specialist | 2228 La Luz Pkwy Unit A, Holloman Afb, NM 88330 | 2016-06-03 |
| 1568849255 | Ryan Abner | Registered Nurse | 49th Medical Building 17, Holloman Afb, NM 88330 | 2015-05-01 |
| 1710384292 | United States Air Force | Military Hospital | 49th Medical Bldg 17, Holloman Afb, NM 88330 | 2014-11-26 |
| 1649512807 | Philip Walker | Internal Medicine | 280 1st St, Holloman Afb, Alamogordo, NM 88330 | 2013-03-25 |
| 1275891889 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | 551 4th Street, Bldg. 227, Holloman Afb, NM 88330 | 2012-05-02 |
| 1568606317 | Kimberly Dawn Jensen | Internal Medicine | 280 1st St Bldg 15, 49 Mdg Holloman Afb, Holloman Afb, NM 88330 | 2009-04-23 |
| 1700042306 | Bettina Watkins | Family Medicine | 280 First St, Bldg 23, Holloman Afb, NM 88330 | 2008-08-03 |
| 1386849024 | Matthew Atwood | Social Worker | 200 First St., Bldg 17, Holloman Afb, NM 88330 | 2007-06-20 |
| Find all providers in zip 88330 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104462092 | Amber D Clayton | Social Worker | 280 1st St # St23, Holloman Afb, NM 88330-8273 | 2019-11-26 |
| 1578658696 | Virginia Marie Mckinley | Social Worker | 49 Mdos/sgoh, 200 First Street, Holloman Afb, NM 88330 | 2006-10-04 |
| 1356898613 | Angelita Baker | Social Worker | 49th Medical Group/sgopf, 280 First Street, Bldg 23, Holloman Afb, NM 88330-8273 | 2016-09-04 |
| 1679935720 | Travis Stevens | Social Worker | 280 1st St, Holloman Afb, NM 88330-8273 | 2016-03-27 |
| 1376896183 | Derandoria Ann Young | Social Worker | 280 1st St, Bldg 17, Holloman Afb, NM 88330-8273 | 2012-10-17 |
| 1609949742 | Crystal Venice Mcleod | Social Worker | 49th Medical Group/sgopf, 280 First Street, Bldg 23, Holloman Afb, NM 88330-8273 | 2006-11-16 |
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|---|---|---|---|---|
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| 1154936573 | Linda M Oberle | Social Worker | 4648 Callejon Urraca, Santa Fe, NM 87507-4507 | 2020-09-11 |
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| Find all providers with the same taxonomy | ||||
| City | HOLLOMAN AFB |
| Zip Code | 88330 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.