Doctor Name: | STEPHANIE R GORDON |
NPI Number: | 1124224688 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LCSW |
License Number: | 631-LCSW |
Business Practice Address: | 5938 Us Highway 93 S Whitefish, MT - 599378415 |
Business Phone Number: | 4068625079 |
Business Fax Number: | 4068639301 |
Mailing Address: | 219 Dakota Ave, WHITEFISH |
State: | MT |
Postal Code: | 599372205 |
Phone Number: | 4068625079 |
Fax Number: | 4068639301 |
NPI Enumeration Date: | 06/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 631-LCSW |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |