Doctor Name: | LESLIE J GORDON |
NPI Number: | 1225186794 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 005108 |
Business Practice Address: | 81 Rossini Rd Westerly, RI - 028914754 |
Business Phone Number: | 4013222678 |
Business Fax Number: | |
Mailing Address: | 81 Rossini Rd, WESTERLY |
State: | RI |
Postal Code: | 028914754 |
Phone Number: | 4013222678 |
Fax Number: | |
NPI Enumeration Date: | 01/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 005108 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |