HOLLY LEE GORDON LCSW NPI 1215169602

NPI Information

  • NPI: 1215169602
  • Provider Name: HOLLY LEE GORDON, LCSW
  • Classification: Social Worker - 104100000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 468 MAIN ST
    MASTIC BEACH, NY
    ZIP 11951
  • Phone: (631) 294-0216

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NPI Details

Holly Lee Gordon, LCSW is a social worker in Mastic Beach, NY with 24 years of experience. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. Holly Lee Gordon, LCSW NPI is 1215169602. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

468 MAIN ST
MASTIC BEACH, NY
ZIP 11951-407
Phone: (631) 294-0216
Fax: (631) 772-6221

The NPI 1215169602 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 8/18/2009 and was last updated on 1/15/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1104100000XSocial Worker079684-1NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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