Gorder, Corey James

Gorder, Corey James is an sole proprietor health care provider with primary practice located at 104 11Th St W Ste. 4, Bottineau ND 58318-2005. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Behavioral Health & Social Service Providers / Counselor is his primary health care specialty. Gorder, Corey James can be contacted via phone (701) 201-0076.

Contact Information

Primary practice address
104 11Th St W Ste. 4 Bottineau ND 58318-2005
Phone: (701) 201-0076
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 569-12-15-06-190 North Dakota
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X 569-12-15-06-190 North Dakota

Profile Details

NPI number 1588800882
LBN Legal business name Gorder, Corey James
Credentials LPCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 17th, 2008
Last updated Jan 6th, 2016 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588800882 NPPES
North Dakota MEDICAID 054517
North Dakota MEDICAID 1225448798
North Dakota Other 1588800882

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