Provider Demographics
NPI:1417206178
Name:GORDON, ELIZABETH (M ED, LMHC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:GORDON
Suffix:
Gender:F
Credentials:M ED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 N SILVER LN
Mailing Address - Street 2:
Mailing Address - City:SUNDERLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01375-9566
Mailing Address - Country:US
Mailing Address - Phone:413-512-9350
Mailing Address - Fax:
Practice Address - Street 1:78 POMEROY TER
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3378
Practice Address - Country:US
Practice Address - Phone:413-584-1310
Practice Address - Fax:413-586-1490
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health