Individual
DR. JONATHAN D GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1358
NJ
103TA0400X
Addiction (Substance Use Disorder) Psychologist
1358
NJ
103TB0200X
Cognitive & Behavioral Psychologist
1358
NJ
103TC0700X
Clinical Psychologist
1358
NJ
103TC1900X
Counseling Psychologist
1358
NJ
103TC2200X
Clinical Child & Adolescent Psychologist
1358
NJ
103TF0000X
Family Psychologist
1358
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5614
PSYCHOLOGIST
NY
01
—
7540
PSYCHOLOGIST
OH
01
—
SIO1358
PSYCHOLOGIST
NJ
Enumeration date
12/01/2017
Last updated
07/27/2022
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