Individual
CLIFFORD I GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
36 BRIDGE WAY, PASCOAG, RI 02859-3131
(401) 568-7661
(401) 245-5762
Mailing address
18 OLD CHIMNEY RD, BARRINGTON, RI 02806-3243
(401) 247-2798
(401) 245-5762
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS00331
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00-5303
BCHIP
RI
01
—
0716
NEIGHBORHOOD
RI
01
—
193805
HARVARD PILGRIM
RI
01
—
304940
BCBS
RI
01
—
411814
MEDICARE GROUP
RI
01
—
61-00445
UNITED HEALTH
RI
05
—
7057168
—
RI
Enumeration date
09/16/2006
Last updated
04/08/2008
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