Individual
AMY ELISABETH GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
811 MARQUETTE AVE NW, UNIT 8, ALBUQUERQUE, NM 87102-1981
(505) 409-5406
Mailing address
811 MARQUETTE AVE NW, UNIT 8, ALBUQUERQUE, NM 87102-1981
(505) 409-5406
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CCMH0222831
NM
101YM0800X
Mental Health Counselor
T-CTL0206531
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27134849
—
NM
Enumeration date
10/22/2019
Last updated
01/05/2024
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