Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Johnnie Gordon

Individual provider Mental Health Counselor · NPI 1134964562

Johnnie Gordon is a Mental Health Counselor in Douglasville, Georgia. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2024

Practice location Address checks out

8471 Newman St
Douglasville, GA 30134-2420
Phone: (678) 386-1338
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LPC016689 (GA)

Record details

NPI number1134964562
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 27, 2024
Last updated in NPPESMay 4, 2026
Certification dateMay 4, 2026
Mailing addressPo Box 1477, Marietta, GA 30061-1477

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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