Provider Demographics
NPI:1548575343
Name:GORDON, FRANCES ANN (MHS, CCS)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:ANN
Last Name:GORDON
Suffix:
Gender:F
Credentials:MHS, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 E SOUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2507
Mailing Address - Country:US
Mailing Address - Phone:334-324-6359
Mailing Address - Fax:
Practice Address - Street 1:2525 E SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2507
Practice Address - Country:US
Practice Address - Phone:334-324-6359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALCCS-301101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health