Gordon, Phyllis Arlene

Gordon, Phyllis Arlene is an individual health care provider with primary practice located at 600 N Holtzclaw Ave Ste 100, Chattanooga TN 37404-1242. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gordon, Phyllis Arlene can be contacted via phone (423) 622-0500.

Contact Information

Primary practice address
600 N Holtzclaw Ave Ste 100 Chattanooga TN 37404-1242
Phone: (423) 622-0500
Fax: (423) 622-0564
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LSW00882 Tennessee

Profile Details

NPI number 1740278688
LBN Legal business name Gordon, Phyllis Arlene
Credentials Master of Science in Social Work (MSSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1740278688 NPPES
Tennessee MEDICAID 3694920

Popular Providers