Individual
MISS CHANTE L GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3307 NORTHLAKE BLVD STE B104, PALM BEACH GARDENS, FL 33403-1703
(954) 501-1273
Mailing address
4751 VIA PALM LKS APT 416, WEST PALM BEACH, FL 33417-2722
(954) 501-1273
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH25921
FL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1041C0700X
1041C0700X
—
Enumeration date
12/15/2021
Last updated
11/05/2025
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