Provider Demographics
NPI:1194388223
Name:GORDON, BRITTANY ANN (LAC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANN
Last Name:GORDON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ANN
Other - Last Name:ANGRISANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:18 KETCH CT
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-3303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:81 NAUTILUS DR
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2448
Practice Address - Country:US
Practice Address - Phone:609-597-5327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health