Individual
DARYL DAVID GORDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LCAS, LPC
Contact information
Practice address
227 N MAIN ST, TROY, NC 27371-3058
(910) 572-3681
(910) 572-5579
Mailing address
284 EXECUTIVE PARK DR, STE 100, CONCORD, NC 28025-1831
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22872
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447706999
—
NC
Enumeration date
08/25/2016
Last updated
11/28/2018
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