NPI 1114285020 · live from the CMS NPI Registry
Brian Gordon
Marriage & Family Therapist in Ft Wainwright, AK. National Provider Identifier 1114285020, active.
NPI record
| NPI | 1114285020 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Marriage & Family Therapist 106H00000X |
| Practice location | 1060 Gaffney Rd Stop 7440, Ft Wainwright, AK 99703 |
| Practice phone | 907-361-5418 |
| Enumerated | April 27, 2012 |
| Last updated | December 27, 2012 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Marriage & Family Therapist primary | 106H00000X | 23380 (CA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.