Doctor Name: | DIANE LYNN GORDON |
NPI Number: | 1316278385 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | R028275-1 |
Business Practice Address: | 1173 Bellmore Rd North Bellmore, NY - 117103757 |
Business Phone Number: | 5162414801 |
Business Fax Number: | 6318537389 |
Mailing Address: | 2675 Doris Ave, NORTH BELLMORE |
State: | NY |
Postal Code: | 117102070 |
Phone Number: | 5162414801 |
Fax Number: | 6318537389 |
NPI Enumeration Date: | 01/14/2010 |
NPI Last Update Date: | 01/14/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | R028275-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |