HOLLY LEE GORDON LCSW
NPI 1215169602
Social Worker in Mastic Beach, NY

Q: What is Holly Gordon's NPI number?

The NPI number for Holly Gordon is 1215169602. It was assigned to this individual provider in the NPPES registry on August 18, 2009. The provider is also known as Holly Gordon Lcsw.

Q: What is Holly Gordon's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Holly Gordon was last updated on January 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 18, 2009PECOS EnrolledAccepts Medicare Assignment

468 MAIN ST, MASTIC BEACH, NY 11951(631) 294-0216(631) 772-6221 Get Directions Write a Review

NPPES record last updated: January 15, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Holly Lee Gordon Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLLY LEE GORDON LCSW (NPI 1215169602) is an individual social worker in Mastic Beach, New York, licensed in New York (079684-1) and active in the NPI registry since August 2009. She is enrolled in Medicare PECOS, maintains a secondary practice location in Center Moriches, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1215169602

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameHOLLY LEE GORDONCredential: LCSW

Location Address468 MAIN STMastic Beach, NY 11951-3407

Mailing Address110 Alcolade Dr EShirley, NY 11967-3839 · (631) 294-0216 · Fax (631) 722-6221

Phone(631) 294-0216

Fax(631) 772-6221

Sole ProprietorYes

Medical School CMSOtherGraduated 2002

Enumeration DateAugust 18, 2009

Last NPPES UpdateJanuary 15, 2025

NPPES CertifiedJanuary 15, 2025

✔ NPI 1215169602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in NY · 079684-1

Definition

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.

468 MAIN ST, Mastic Beach, NY 11951

Open in Google Maps ↗

Other Names 1

Professional Name (2)Holly Gordon Lcsw

Secondary Practice Location 1

Location 1408 Main St SouthCenter Moriches, NY 11934 · Phone (631) 772-6220 · Fax (631) 772-6221

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Holly Lee Gordon Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547579211

PECOS Enrollment IDI20151020000881

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMMA ELIZABETH JOHNSEN LMSW

Social Worker