Individual
ROBERT GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED.
Contact information
Practice address
3550 CONCORD RD, SUITE 4, YORK, PA 17402-8626
(717) 851-6340
(717) 851-6349
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-6340
(717) 851-6349
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PS002355L
PA
103TB0200X
Cognitive & Behavioral Psychologist
PS002355L
PA
103TC0700X
Clinical Psychologist
Primary
PS002355L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01097501
CAPITAL BLUE CROSS
PA
01
—
119323
VALUE OPTIONS
PA
01
—
2176815
CIGNA BEHAVIORAL HEALTH
PA
01
—
279849000
MAGELLAN
PA
01
—
GO154450
PA BLUE SHIELD
PA
Enumeration date
06/15/2006
Last updated
06/13/2016
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