Individual
MS. LUCILLE COURSEN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LISW CP
Contact information
Practice address
1528 BLANDING ST, COLUMBIA, SC 29201
(803) 252-9444
Mailing address
3501 MONROE ST, COLUMBIA, SC 29205
(803) 254-1888
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LISW255
SC
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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