Individual
MR. GORDON MCINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
307 BROADVIEW RD, WAYNESVILLE, NC 28786-3466
(828) 631-3973
Mailing address
PO BOX 2187, SYLVA, NC 28779-2187
(828) 631-3973
(828) 631-9280
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4595
NC
101YP2500X
Professional Counselor
Primary
4595
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102038
—
NC
Enumeration date
05/16/2006
Last updated
11/19/2019
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