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Individual
MRS. LYNNETTE ANN GORDON
Active
Individual
MRS. LYNNETTE ANN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LCAS, CRC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4457
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
987
NC
101YP2500X
Professional Counselor
4457
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4457
LIC PROFESS. COUNSELOR
NC
05
—
61003110
—
NC
01
—
987
LIC. CLIN. ADDICTION SPEC
NC
Enumeration date
03/14/2007
Last updated
02/09/2010
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