Lisa Beth Gordon is a Clinical in Evanston, Illinois. Lisa Beth Gordon practices all healthcare services and medical treatments related to Clinical. The NPI Number for Lisa Beth Gordon is 1407024771. The last update date is 2008-02-20.
Lisa Beth Gordon's current location address is 618 Library Place, Evanston, Illinois. You can contact this provider via phone number 8477334300 and fax number 8477330390. The mailing address for Lisa Beth Gordon is 618 Library Place, Evanston, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lisa Beth Gordon |
|---|---|
| Address | 618 Library Place, Evanston, Illinois |
| Phone Number | 8477334300 |
| Fax Number | 8477330390 |
| Sole Proprietor | N |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1407024771 |
|---|---|
| Provider Enumeration Date | 2008-02-20 |
| Last Updated Date | 2008-02-20 |
Provider Mailing Address Detail
| Address | 618 Library Place |
|---|---|
| City | Evanston |
| State | Illinois (IL) |
| Post Code | 602012908 |
| Phone Number | 8477334300 |
| Fax Number | 8477330390 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PY6692 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| U26622 | FL | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Lisa Beth Gordon by the Centers for Medicare & Medicaid Services (CMS)?
The Lisa Beth Gordon has been assigned the NPI (National Provider Identifier) 1407024771. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete address where Lisa Beth Gordon is physically located?
The Lisa Beth Gordon is situated at the following address: 618 Library Place, Evanston, IL 602012908.
What is the area of specialization for Lisa Beth Gordon, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Lisa Beth Gordon is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 103Tc0700X.
When did Lisa Beth Gordon receive its 1407024771 assignment?
The Lisa Beth Gordon was assigned its 1407024771 on 2008-02-20, which is the date when this unique identifier was issued to the organization.
As of what date were the details related to Lisa Beth Gordon most recently updated or revised?
The information pertaining to Lisa Beth Gordon, including its address, specialty, and other relevant details, was last updated or revised on 2008-02-20.