Individual
MR. GORDON DEAN BATHEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5210 E PIMA ST, SUITE #140, TUCSON, AZ 85712-3664
(520) 275-6780
(520) 795-3575
Mailing address
5210 E PIMA ST STE 115, TUCSON, AZ 85712-3691
(520) 275-6780
(520) 795-3575
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-0167
AZ
1041C0700X
Clinical Social Worker
Primary
LCSW-0974
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CSW9741
—
AZ
Enumeration date
07/23/2006
Last updated
04/18/2020
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