Provider Demographics
NPI:1659143519
Name:GORDON, ALEXANDER SCRANTON I (LMFT)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:SCRANTON
Last Name:GORDON
Suffix:I
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 PALISADES DR
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-2116
Mailing Address - Country:US
Mailing Address - Phone:310-963-1598
Mailing Address - Fax:
Practice Address - Street 1:1760 PALISADES DR
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-2116
Practice Address - Country:US
Practice Address - Phone:310-963-1598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT140009106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist