Provider Demographics
NPI:1407879778
Name:GORDON, FRANCES FRIEDENSEN (MED, LPC, LCAS)
Entity Type:Individual
Prefix:MRS
First Name:FRANCES
Middle Name:FRIEDENSEN
Last Name:GORDON
Suffix:
Gender:F
Credentials:MED, LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 WESTOAK TRL
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-2628
Mailing Address - Country:US
Mailing Address - Phone:336-760-0316
Mailing Address - Fax:
Practice Address - Street 1:370 WESTOAK TRL
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-2628
Practice Address - Country:US
Practice Address - Phone:336-760-0316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC194101YA0400X
NC708101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8100046Medicaid
NC04388OtherBLUE CROSS/BLUE SHIELD OF
NC15877OtherUBS
NC15877OtherUBS