Gordon, Sandra R

Gordon, Sandra R is an individual health care provider with primary practice located at 3737 Lander Rd , Pepper Pike OH 44124-5712. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Gordon, Sandra R can be contacted via phone (216) 831-2255.

Contact Information

Primary practice address
3737 Lander Rd Pepper Pike OH 44124-5712
Phone: (216) 831-2255
Fax: (216) 378-3906
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X E.0500895-SUPV Ohio
Behavioral Health & Social Service Providers / Professional 101YP2500X E.0500895-SUPV Ohio
Behavioral Health & Social Service Providers / Professional 101YP2500X C.0500895 Ohio
Behavioral Health & Social Service Providers / Professional 101YP2500X E.0500895 Ohio

Profile Details

NPI number 1891002721
LBN Legal business name Gordon, Sandra R
Credentials LPCC-SUPV
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2010
Last updated Mar 18th, 2016 - about 8 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 1891002721 NPPES
Ohio MEDICAID 0268768
Ohio MEDICAID 2871101

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