Provider Demographics
NPI:1215009824
Name:GORDON, BARBARA TOBIAS (MSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:TOBIAS
Last Name:GORDON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N OLD WOODWARD AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-1322
Mailing Address - Country:US
Mailing Address - Phone:248-642-8263
Mailing Address - Fax:248-642-3682
Practice Address - Street 1:700 N OLD WOODWARD AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-1322
Practice Address - Country:US
Practice Address - Phone:248-642-8263
Practice Address - Fax:248-642-3682
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010080341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical