Provider Demographics
NPI:1427381276
Name:GORDON, JANET E (MED LPC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:E
Last Name:GORDON
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1765
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-4765
Mailing Address - Country:US
Mailing Address - Phone:970-379-4983
Mailing Address - Fax:970-704-9158
Practice Address - Street 1:1101 VILLAGE RD
Practice Address - Street 2:UL3C
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-2518
Practice Address - Country:US
Practice Address - Phone:970-379-4983
Practice Address - Fax:970-704-9158
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC-3543101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional