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Deactivated NPI 1447020243 Deactivated / Inactive NPI Male Practitioner

Dr. Scott Gordon , PsyD

Psychologist • Berkeley, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Scott Gordon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 03, 2024
NPI Deactivation Date January 09, 2024
Total Practice Duration ~1 Years of Practice (2024 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Scott Gordon, PsyD was a registered Psychologist practicing in Berkeley, CA. Throughout an active medical career spanning 1 years, Dr. Gordon provided care at the practice location at 2915 MARTIN LUTHER KING JR WAY until profile deactivation on 2024-01-09.

Practice Location & Contact Primary Location

Practice Address

2915 Martin Luther King Jr Way

Berkeley, CA 947032133

Telephone 5104859655
Associated Practice Facility / Clinic
🏢 Lara Benefield, Lmft Facility NPI 1386261436

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Berkeley, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 30.3 Yrs
State Avg: 24.2 Yrs
Regional Practice Density
122 Specialists

Practicing in Berkeley, CA (7695 Statewide)

Telehealth Adoption Rate
6.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-10-24
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License CA PSY36173

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

12 Associated Practitioners
Sarah Gold , MFT

Marriage & Family Therapist

NPI 1063550796

Marriage and Family Therapist

Ariana Candell , MA

Marriage & Family Therapist

NPI 1073770061

Master of Arts

Zvi Bellin , LPCC

Counselor - Professional

NPI 1073864534

Licensed Professional Clinical Counselor

Danielle Short , AMFT #

Marriage & Family Therapist

NPI 1104502889

AMFT#

Alexandria Wright , LCSW

Social Worker - Clinical

NPI 1154672491

Licensed Clinical Social Worker

David Heliotis , LPCC

Counselor - Mental Health

NPI 1366996878

Licensed Professional Clinical Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location October 24, 2025

Registered at 2915 MARTIN LUTHER KING JR WAY, BERKELEY, CA 947032133 (Tel: 5104859655)

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Updated Business Mailing Address October 24, 2025

Registered at 1442A WALNUT ST # 326, BERKELEY, CA 947091405 (Tel: 5104859655)

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Provider Name / Credentials Updated October 24, 2025

Recorded as SCOTT GORDON, PSYD

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 24, 2025

Psychologist (License #PSY36173 in CA)

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NPI Profile Deactivated January 09, 2024

Record deactivated on January 09, 2024

NPI Profile Active January 03, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location January 03, 2024

Registered at 2475 WASHINGTON ST STE 3, SAN FRANCISCO, CA 941151816 (Tel: 5104859655)

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Updated Business Mailing Address January 03, 2024

Registered at 2475 WASHINGTON ST STE 3, SAN FRANCISCO, CA 941151816 (Tel: 5104859655)

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Provider Name / Credentials Updated January 03, 2024

Recorded as SCOTT GORDON

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 03, 2024

Psychologist (License #PSB94027444 in CA)

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Initial NPI Registration & Enumeration January 03, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1447020243
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 03, 2024
Last Update: October 24, 2025
Deactivation Date: January 09, 2024
Sole Proprietor: Yes

Mailing Address

1442a Walnut St # 326

Berkeley, CA 947091405

Phone: 5104859655

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.