Provider Demographics
NPI:1508433996
Name:GORDON, ASHLEY C (MSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:C
Last Name:GORDON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:C
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:5880 NW 19TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-4007
Mailing Address - Country:US
Mailing Address - Phone:786-428-7319
Mailing Address - Fax:
Practice Address - Street 1:5880 NW 19TH ST APT A
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-4007
Practice Address - Country:US
Practice Address - Phone:786-428-7319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-05
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker