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Deactivated NPI 1124643432 Deactivated / Inactive NPI Female Practitioner

Dr. Kayla Ruth Gordon , PhD, BCBA, LABA

Psychologist • Randolph, MA

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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. Kayla Gordon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 11, 2020
NPI Deactivation Date June 21, 2021
Total Practice Duration ~1 Years of Practice (2020 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Kayla Gordon, PhD, BCBA, LABA was a registered Psychologist practicing in Randolph, MA. Throughout an active medical career spanning 1 years, Dr. Gordon provided care at the practice location at 41 PACELLA PARK DR until profile deactivation on 2021-06-21.

Practice Location & Contact Primary Location

Practice Address

41 Pacella Park Dr

Randolph, MA 023681755

Telephone 4133863592
Associated Practice Facility / Clinic
🏢 The May Institute, Inc Facility NPI 1356318125

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Randolph, MA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 32.3 Yrs
Regional Practice Density
8 Specialists

Practicing in Randolph, MA (2533 Statewide)

Telehealth Adoption Rate
0.0% 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

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License MA 11202-PY-PR

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

40 Associated Practitioners
Kafunda Banks

Counselor - Mental Health

NPI 1003115494
Rene Schwiesow

Counselor - Mental Health

NPI 1003181272
Sacha Shaw

Behavior Analyst

NPI 1013531540
Aahliyanah Goncalves

Behavior Technician

NPI 1013783547
Krista Canon , BCBA

Behavior Analyst

NPI 1023257292

Board Certified Behavior Analyst

Madeline Mckeever

Counselor - Mental Health

NPI 1023547767

Career & Practice History Timeline

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

8 Historical Events
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NPI Profile Deactivated June 21, 2021

Record deactivated on June 21, 2021

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Updated Business Mailing Address March 30, 2021

Registered at 41 PACELLA PARK DR, RANDOLPH, MA 023681755

NPI Profile Active June 11, 2020

NPI status registered as active in NPPES database

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Updated Practice Location June 11, 2020

Registered at 41 PACELLA PARK DR, RANDOLPH, MA 023681755 (Tel: 4133863592)

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Updated Business Mailing Address June 11, 2020

Registered at 2 AVALON DR UNIT 2314, QUINCY, MA 021692472 (Tel: 4133863592)

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Provider Name / Credentials Updated June 11, 2020

Recorded as KAYLA GORDON, PHD, BCBA, LABA

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 11, 2020

Psychologist (License #11202-PY-PR in MA)

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Initial NPI Registration & Enumeration June 11, 2020

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: 1124643432
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 11, 2020
Last Update: June 11, 2020
Deactivation Date: June 21, 2021

Mailing Address

2 Avalon Dr Unit 2314

Quincy, MA 021692472

Phone: 4133863592

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.