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Organization
TRAUMCORE
Active
Organization
TRAUMCORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCINE GORDON LCSW (DIRECTOR)
(770) 415-3601
Entity
Organization
Contact information
Practice address
12461 VETERANS MEMORIAL HWY STE 631, DOUGLASVILLE, GA 30134-2025
(770) 415-3601
(678) 534-8986
Mailing address
6000 STEWART PKWY UNIT 6271, DOUGLASVILLE, GA 30154-1114
(770) 415-3601
(678) 534-8986
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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