Doctor Name: | JERRY GORDON |
NPI Number: | 1235396441 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC, M.ED |
License Number: | 770 |
Business Practice Address: | 8500 N Stemmons Fwy Suite#4015-h Dallas, TX - 752473832 |
Business Phone Number: | 2148822269 |
Business Fax Number: | |
Mailing Address: | 8500 N Stemmons Fwy, Suite#4015-h DALLAS |
State: | TX |
Postal Code: | 752473832 |
Phone Number: | 2148822269 |
Fax Number: | |
NPI Enumeration Date: | 05/16/2008 |
NPI Last Update Date: | 05/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 770 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |