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Organization
ELLEN J GORDON LICENSED MASTER SOCIAL WORKER PC
Active
Organization
ELLEN J GORDON LICENSED MASTER SOCIAL WORKER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN GORDON (LCSW)
(631) 649-6278
Entity
Organization
Contact information
Practice address
8 ROOSEVELT AVE, PORT JEFFERSON STATION, NY 11776-3337
(631) 736-7707
Mailing address
507 EMPIRE AVE, WEST BABYLON, NY 11704-3306
(631) 649-6278
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/10/2020
Last updated
03/09/2022
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