Provider Demographics
NPI:1912002254
Name:GORDON, NATALIE STRANITI (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:STRANITI
Last Name:GORDON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 JAMES ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-2895
Mailing Address - Country:US
Mailing Address - Phone:315-449-0717
Mailing Address - Fax:
Practice Address - Street 1:2507 JAMES ST
Practice Address - Street 2:SUITE 206
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206-2895
Practice Address - Country:US
Practice Address - Phone:315-449-0717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2009-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000018106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
16-1659182OtherEIN