MRS. SHIRLEY L GORDON CAC CMHT CPRS NPI 1003485962

NPI Information

NPI: 1003485962
Provider Name: MRS. SHIRLEY L GORDON, CAC, CMHT, CPRS
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
92 W WASHINGTON ST
ANNAPOLIS, MD
ZIP 21401
Phone: (443) 949-9545
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MRS. Shirley L Gordon, CAC, CMHT, CPRS is an addiction (substance use disorder) counselor in Annapolis, MD. MRS. Shirley L Gordon, CAC, CMHT, CPRS NPI is 1003485962. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

92 W WASHINGTON ST
ANNAPOLIS, MD
ZIP 21401-432
Phone: (443) 949-9545
Fax: (240) 366-0055

The enumeration date for this NPI number is 6/23/2021 and was last updated on 10/5/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	DISTRICT OF COLUMBIA	No
2	101YM0800X	Counselor	Mental Health		No
3	175T00000X	Peer Specialist		DISTRICT OF COLUMBIA	No
4	175T00000X	Peer Specialist		MARYLAND	No
5	101YA0400X	Counselor	Addiction (Substance Use Disorder)		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G635765549569	OTHER	MARYLAND	STATE ISSUED ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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