Gordon, Athena A

Gordon, Athena A is an individual health care provider with primary practice located at 904 E. Martin Luther King Dr , Centralia IL 62801. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Gordon, Athena A can be contacted via phone (618) 533-1391.

Contact Information

Primary practice address
904 E. Martin Luther King Dr Centralia IL 62801
Phone: (618) 533-1391
Fax: (618) 533-0012
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1376082685
LBN Legal business name Gordon, Athena A
Credentials M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2017
Last updated Jan 31st, 2023 - about last year

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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