OCTAVIA D GORDON (NPI# 1467066480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467066480 |
| Entity Type | Individual |
| Full Name | OCTAVIA D GORDON |
| Practice Address |
80 Commercial St Holyoke MA 01040-4704 |
| Mailing Address |
147 Norman St West Springfield MA 01089-5003 |
| Practice Telephone | 4138460445 |
| Mailing Telephone | 4138460445 |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | MEDICARE | Y10086 | 01 |
| MA | 1134107113 | 05 |
| Street Address |
80 COMMERCIAL ST |
| City | HOLYOKE |
| State | MA |
| Zip Code | 01040-4704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760803779 | Sara Grzejszczak Fernandes | Counselor | 80 Commercial St, Holyoke, MA 01040 | 2013-12-17 |
| 1033710033 | Ginamari Pereira | Counselor | 80 Commercial St, Holyoke, MA 01040-4704 | 2020-11-05 |
| 1760082986 | Jasline E Perez Perez | Counselor | 80 Commercial St, Holyoke, MA 01040-4704 | 2020-10-27 |
| 1730788027 | Matheus Fernandez-monteiro | Counselor | 80 Commercial St, Holyoke, MA 01040-4704 | 2020-10-19 |
| 1558978163 | Carmen Gloria Osorio Rodriguez | Counselor | 80 Commercial St, Holyoke, MA 01040-4704 | 2020-09-28 |
| 1174137103 | Denisha A Concepcion | Counselor | 80 Commercial St, Holyoke, MA 01040-4704 | 2020-09-08 |
| 1942814975 | Bel B Bhujel | Counselor | 80 Commercial St, Holyoke, MA 01040-4704 | 2020-09-08 |
| 1114542214 | Lauren Ann Malvezzi | Counselor | 80 Commercial St, Holyoke, MA 01040-4704 | 2020-06-15 |
| 1003431107 | Jacqueline Nieves | Counselor | 80 Commercial St, Holyoke, MA 01040-4704 | 2020-06-15 |
| 1982226569 | Joscelyn Pacheco | Counselor | 80 Commercial St, Holyoke, MA 01040-4704 | 2020-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255945325 | Holyoke Care Center, LLC | Skilled Nursing Facility | Holyoke Care Center, LLC, 35 Holy Family Road, Holyoke, MA 01040 | 2020-09-04 |
| 1225646904 | Jasmine Glover | Counselor | 476 Appleton St. Suite 5, Holyoke, MA 01040 | 2020-07-17 |
| 1932662319 | Damaris Santingo Martinez | Registered Nurse | 46 Magnolia Ave, Holyoke, MA 01040 | 2019-04-11 |
| 1104302371 | Cheryl Ann Lauben | Counselor | 476 Appleton Street, Suite 2, Holyoke, MA 01040 | 2018-07-11 |
| 1740704741 | Miranda Lynn Fogg | Behavior Technician | 244 Westfield Rd, Holyoke, MA 01040 | 2017-08-01 |
| 1770020018 | Total Wellness Centers, LLC | Clinical Medical Laboratory | 59 Bobala Rd, Holyoke, MA 01040 | 2017-01-25 |
| 1184097768 | Chi Wan Wong | Physical Therapy Assistant | 110 Cherry Street, Holyoke, MA 01040 | 2015-11-04 |
| 1841666724 | Danielle Moroney | Counselor | River Valley Counseling Center Mental Health Service, 303 Beech St, Holyoke, MA 01040 | 2015-08-14 |
| 1285019638 | Ashley Papineau | Social Worker | 9 Faille Ave, Apt 3, Holyoke, MA 01040 | 2015-07-28 |
| 1205216967 | Vanessa Vazquez | Counselor | 1233 Main St., Holyoke, MA 01040 | 2015-06-08 |
| Find all providers in zip 01040 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225646904 | Jasmine Glover | Counselor | 476 Appleton St. Suite 5, Holyoke, MA 01040 | 2020-07-17 |
| 1104302371 | Cheryl Ann Lauben | Counselor | 476 Appleton Street, Suite 2, Holyoke, MA 01040 | 2018-07-11 |
| 1588155931 | Takiah Sade Helton | Counselor | 1221 Main St Ste 309, Holyoke, MA 01040-5396 | 2018-05-22 |
| 1801344965 | Cassidy Melendez | Counselor | 471 Beech St, Holyoke, MA 01040-2238 | 2016-09-19 |
| 1841666724 | Danielle Moroney | Counselor | River Valley Counseling Center Mental Health Service, 303 Beech St, Holyoke, MA 01040 | 2015-08-14 |
| 1326431529 | Kristian Villegas | Counselor | 19 Beacon Avenue, Holyoke, MA 01040 | 2015-03-12 |
| 1932532025 | Francisca Antonetti | Counselor | 255 Maple St., Holyoke, MA 01040 | 2013-08-13 |
| 1023354305 | Erin Elizabeth Hervieux | Counselor | 39 Evergreen Drive, Holyoke, MA 01040 | 2012-12-14 |
| 1659602894 | Gia Catanzarite | Counselor | 494 Appleton Street, Center for Human Development, Holyoke, MA 01040 | 2010-01-28 |
| 1033710033 | Ginamari Pereira | Counselor | 80 Commercial St, Holyoke, MA 01040-4704 | 2020-11-05 |
| Find all providers in HOLYOKE | ||||
Please comment or provide details below to improve the information on OCTAVIA D GORDON.
| 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.