Tom Gordon Lcsw Therapy, Pllc | |
45 John Street Goshen NY 10924-1092 | |
(914) 810-3177 | |
Not Available |
Full Name | Tom Gordon Lcsw Therapy, Pllc |
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Speciality | Psychoanalyst |
Location | 45 John Street, Goshen, New York |
Authorized Official Name and Position | Thomas Wayne Gordon (OWNER) |
Authorized Official Contact | 9149241598 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tom Gordon Lcsw Therapy, Pllc 3701 Whispering Hls Chester NY 10918-1555 Ph: (914) 810-3317 | Tom Gordon Lcsw Therapy, Pllc 45 John Street Goshen NY 10924-1092 Ph: (914) 810-3177 |
NPI Number | 1356040356 |
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Provider Enumeration Date | 02/28/2023 |
Last Update Date | 02/28/2023 |
Certification Date | 02/24/2023 |
Medicare PECOS PAC ID | 9739546177 |
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Medicare Enrollment ID | O20230531000734 |
Identifier | Type | State | Issuer |
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1356040356 | NPI | - | NPPES |
1508317363 | Other | NY | NPI PERSONAL |
Taxonomy | Type | License (State) | Status |
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102L00000X | Psychoanalyst | (* (Not Available)) | Primary |
Provider Name | Thomas W Gordon |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1508317363 PECOS PAC ID: 6103283544 Enrollment ID: I20230531000730 |
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