Provider Demographics
NPI:1083958052
Name:GORDON, NANCY KNIGHT (CSAC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:KNIGHT
Last Name:GORDON
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3289 WOODBURN RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-7355
Mailing Address - Country:US
Mailing Address - Phone:703-207-7529
Mailing Address - Fax:703-208-6025
Practice Address - Street 1:3289 WOODBURN RD STE 300
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-7355
Practice Address - Country:US
Practice Address - Phone:703-207-7529
Practice Address - Fax:703-208-6025
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)