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MRS. CALLIE GORDON LPC
NPI 1760061097
Counselor - Professional in San Angelo, TX

Active since April 05, 2021PECOS EnrolledAccepts Medicare Assignment
3555 KNICKERBOCKER RD, SAN ANGELO, TX 76904(325) 747-2225(325) 747-8034 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 1, 2025, Apr 5, 2021 (2 updates tracked since 2021).

About Mrs. Callie Gordon Lpc NPPES

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

MRS. CALLIE GORDON LPC (NPI 1760061097) is an individual professional provider in San Angelo, Texas, licensed in Texas (79618) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1760061097
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. CALLIE GORDONCredential: LPC
Location Address3555 KNICKERBOCKER RDSan Angelo, TX 76904-7610
Mailing Address3555 Knickerbocker RdSan Angelo, TX 76904-7610 · (325) 747-2225 · Fax (325) 747-8034
Phone(325) 747-2225
Fax(325) 747-8034
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateApril 5, 2021
Last NPPES UpdateJuly 1, 20252 updates tracked since enumeration
NPPES CertifiedJuly 1, 2025
✔ NPI 1760061097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in TX · 79618
3555 KNICKERBOCKER RD, San Angelo, TX 76904
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Callie Gordon Lpc 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 ID3971949413
PECOS Enrollment IDI20240307000551
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.

Medicare Billing Reassignment

Medicare enrollment records show Callie Gordon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Shannon Clinic
3.8 mi
Family Medicine
120 E BEAUREGARD AVE
San Angelo, TX 76903
  • Reassigned Medicare billing, Texas enrollment
  • 671 clinicians in this Medicare group
NPI 1770587149 (325) 658-1511

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

BRIAN FRANCIS DOOLEY MB BCH BAO
Student in an Organized Health Care Education/Training Program
3555 KNICKERBOCKER RD
SAN ANGELO, TX 76904
Tom Green County (325) 747-7670
SARA ELIZABETH HALFMANN M.D.
Pediatrics
3555 KNICKERBOCKER RD
SAN ANGELO, TX 76904
Tom Green County (325) 949-9555
DR. CHRISTIAN GUTIERREZ MD
Student in an Organized Health Care Education/Training Program
3555 KNICKERBOCKER RD
SAN ANGELO, TX 76904
Tom Green County (325) 747-1511
KRISTENE AMANDA LEEK FNP-C
Nurse Practitioner (Family)
3555 KNICKERBOCKER RD
SAN ANGELO, TX 76904
Tom Green County (325) 224-5366
DR. NATALIA HOLGERSON MD
Family Medicine
3555 KNICKERBOCKER RD
SAN ANGELO, TX 76904
Tom Green County (325) 747-7670
MR. THOMAS KENT ROBERSON LPC
Counselor (Professional)
3555 KNICKERBOCKER RD
SAN ANGELO, TX 76904
Tom Green County (325) 747-2225
WILLIAM PRICKETT LPA
Psychologist
3555 KNICKERBOCKER RD
SAN ANGELO, TX 76904
Tom Green County (325) 747-2225
DR. REBECCA CRENSHAW MD
Psychiatry & Neurology (Neurology)
3555 KNICKERBOCKER RD
SAN ANGELO, TX 76904
Tom Green County (325) 949-9555

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Callie Gordon's NPI number?

The NPI number for Callie Gordon is 1760061097. It was assigned to this individual provider in the NPPES registry on April 5, 2021.

Where is Callie Gordon located?

Callie Gordon practices at 3555 Knickerbocker Rd, San Angelo, TX 76904. The listed phone number is (325) 747-2225.

What is Callie Gordon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Callie Gordon enrolled in Medicare?

Yes. Callie Gordon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Callie Gordon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Callie Gordon reassigns Medicare benefits to Shannon Clinic (San Angelo, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Callie Gordon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Callie Gordon accept?

Health plans from Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas and Cigna Healthcare list Callie Gordon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Callie Gordon was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.