Gordon, Aqualus Mondrell

Gordon, Aqualus Mondrell is an sole proprietor health care provider with primary practice located at 1320 Ne Windsor Dr , Lees Summit MO 64086-8477. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Gordon, Aqualus Mondrell can be contacted via phone (816) 287-8959.

Contact Information

Primary practice address
1320 Ne Windsor Dr Lees Summit MO 64086-8477
Phone: (816) 287-8959
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X 2020017925 Missouri
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2020017925 Missouri

Profile Details

NPI number 1235729575
LBN Legal business name Gordon, Aqualus Mondrell
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 20th, 2021
Last updated Jan 20th, 2021 - about 3 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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