Amy Gordon, M.Ed LABA
Behavior Analyst in Plymouth, MA. Individual provider (NPI-1).
NPI number1316630684
StatusActive
Last updated in NPPESJun 1, 2023
Details
- NPI
- 1316630684
- Entity type
- Individual (NPI-1)
- Name
- Amy Gordon
- Credential
- M.Ed LABA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 1, 2023
- Certification date
- Jun 1, 2023
- Last updated
- Jun 1, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | 2057 | MA | Yes |
Practice location
29 S Park AvePlymouth, MA 02360-3831
Phone 508-975-1160
Mailing address
29 S Park AvePlymouth, MA 02360-3831
Phone 508-975-1160
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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