Individual
NICOLE ANGELA KELLY-GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
(928) 853-2360
(928) 853-2360
Mailing address
PO BOX 1231, TUCSON, AZ 85702-1231
(520) 670-3909
(520) 309-2560
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-15933
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123528
—
AZ
Enumeration date
03/14/2016
Last updated
04/20/2026
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