Individual
MS. DIANE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6709 BERKSHIRE DR, TEMPLE HILLS, MD 20748-4060
(313) 608-5307
Mailing address
6709 BERKSHIRE DR, TEMPLE HILLS, MD 20748-4060
(313) 608-5307
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC200001959
DC
1041C0700X
Clinical Social Worker
6801059388
MI
1041C0700X
Clinical Social Worker
Primary
LC200001959
DC
Other
Enumeration date
02/05/2007
Last updated
11/12/2025
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