Organization
CALLISTA GORDON THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CALLISTA GORDON MSW, LCSW (OWNER)
(574) 220-4701
Entity
Organization
Contact information
Practice address
53846 GENERATIONS DR, SOUTH BEND, IN 46635-1543
(574) 701-2799
Mailing address
503 DOWNEY AVE, MISHAWAKA, IN 46544-3455
(574) 220-4701
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/30/2024
Last updated
08/30/2024
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