Faison, Gordon Lane
Faison, Gordon Lane is an individual health care provider with primary practice located at 54 Harris Place , Brattleboro VT 05301. He recently has only one registered license in Behavioral Health & Social Service Providers / Group Psychotherapy, which is considered as his primary health care specialty. Faison, Gordon Lane can be contacted via phone (802) 380-0695.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Group Psychotherapy | 103TP2701X | 068-0000321 | Vermont |
Profile Details
| NPI number | 1710192935 |
|---|---|
| LBN Legal business name | Faison, Gordon Lane |
| Credentials | NA LCMHC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 11th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710192935 | NPPES |
| Vermont | MEDICAID | 1008170 |
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