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Individual
JESSICA RAE GORDON
Active
Individual
JESSICA RAE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NY
1041C0700X
Clinical Social Worker
Primary
099310-01
NY
Other
Enumeration date
11/03/2022
Last updated
06/30/2026
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