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NPI Code Detail

MEDICARE: CORY RAHEEM GORDY

MEDICARE: CORY RAHEEM GORDY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerLG50082954DC

General Provider Information

NPI Number : 1467317404
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORY RAHEEM GORDY
Provider Business Mailing Address
First Line : 805 CHANNING PL NE APT 412
Second Line :
City : WASHINGTON
State : DC
Zip : 20018-1779
Country : US
Telephone Number : 205-777-8657
Fax Number :
Provider Business Practice Location Address
First Line : 4017 MINNESOTA AVE NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-3541
Country : US
Telephone Number : 202-388-9202
Fax Number : 202-388-4339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2025
Last Update Date : 12/22/2025

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Directions to “ CORY RAHEEM GORDY ” Practice Location

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