Individual
JESSICA ELIZABETH GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 N HIGH ST, LANSING, MI 48906-4597
(517) 372-4700
Mailing address
1717 N HIGH ST, LANSING, MI 48906-4597
(517) 372-4700
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
MI
101YP2500X
Professional Counselor
Primary
6401018026
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265994206
—
MI
Enumeration date
04/01/2019
Last updated
05/07/2026
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