AMANDA GORDON PH.D.
NPI 1831074186
Psychologist - Clinical Child & Adolescent in Bloomington, MN

Q: What is Amanda Gordon's NPI number?

The NPI number for Amanda Gordon is 1831074186. It was assigned to this individual provider in the NPPES registry on August 6, 2025.

Q: What is Amanda Gordon's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Gordon was last updated on November 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 06, 2025PECOS Enrolled

1801 AMERICAN BLVD E STE 1, BLOOMINGTON, MN 55425(612) 767-7222 Get Directions Write a Review

NPPES record last updated: November 8, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 8, 2025, Aug 6, 2025 (2 updates tracked since 2025).

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About Amanda Gordon Ph.d. NPPES

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

AMANDA GORDON PH.D. (NPI 1831074186) is an individual clinical child & adolescent provider in Bloomington, Minnesota, licensed in Minnesota (LP7283) and active in the NPI registry since August 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1831074186

Entity TypeIndividualFemale

Primary Taxonomy103TC2200X

Provider Legal NameAMANDA GORDONCredential: PH.D.

Location Address1801 AMERICAN BLVD E STE 1Bloomington, MN 55425-1230

Mailing Address1801 American Blvd EBloomington, MN 55425-1232

Phone(612) 767-7222

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateAugust 6, 2025

Last NPPES UpdateNovember 8, 20252 updates tracked since enumeration

NPPES CertifiedNovember 8, 2025

✔ NPI 1831074186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

License✔ Licensed in MN · LP7283

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

1801 AMERICAN BLVD E STE 1, Bloomington, MN 55425

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Gordon Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4880186097

PECOS Enrollment IDI20251125002276

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 20

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

DR. DREW BENSON PH.D., L.P.

Psychologist