Organization
TOM GORDON LCSW THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS WAYNE GORDON LCSW (OWNER)
(914) 924-1598
Entity
Organization
Contact information
Practice address
45 JOHN STREET, GOSHEN, NY 10924-1092
(914) 810-3177
Mailing address
3701 WHISPERING HLS, CHESTER, NY 10918-1555
(914) 810-3317
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508317363
NPI PERSONAL
NY
Enumeration date
02/28/2023
Last updated
02/28/2023
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