Provider Demographics
NPI:1649410747
Name:GORDON, CLAUDIA HALLER (MN, LMFT)
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:HALLER
Last Name:GORDON
Suffix:
Gender:F
Credentials:MN, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 HAMPSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5069
Mailing Address - Country:US
Mailing Address - Phone:985-774-4712
Mailing Address - Fax:985-641-2859
Practice Address - Street 1:2151 HAMPSHIRE DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-5069
Practice Address - Country:US
Practice Address - Phone:985-774-4712
Practice Address - Fax:985-641-2859
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1124106H00000X
LARN027054163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health