Individual
ELAINE AAREN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
27656
IL
1041C0700X
Clinical Social Worker
149-014232
IL
1041C0700X
Clinical Social Worker
Primary
149.014232
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149-014232
LCSW
IL
Enumeration date
07/07/2011
Last updated
12/10/2012
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