Individual
AMBER GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW 115164
Contact information
Practice address
3055 WILSHIRE BLVD STE 300, LOS ANGELES, CA 90010-1147
(213) 375-3830
(213) 553-1833
Mailing address
3055 WILSHIRE BLVD STE 300, LOS ANGELES, CA 90010-1147
(213) 434-2566
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ASW97513
—
CA
Enumeration date
11/22/2020
Last updated
06/16/2023
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