Susan Theresa Gordon, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

301445 Issued in MN

Practice address

4227 9TH Ave SW
Fargo, ND 58103-2018

Phone

(701) 282-6561

NPI assigned

Sep 18, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1275729881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 11TH ST N",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565602083",
            "telephone_number": "218-233-6398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4227 9TH AVE SW",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032018",
            "telephone_number": "701-282-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "SUSAN",
        "middle_name": "THERESA",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "301445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADC",
            "identifier": "301445",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jena Gorden, MS CCC-SLP
• Arianna Nicole Gorder, SLP
• Beth Ann Gorder, HIS
• Kathryn Gordon, PHD
• Steven D Gordon, LADC
• Rufus Wade Gore, M.D.
• Stacey Kimball Gorter, DPT
• Taylor Marie Gorter, APRN
• Anne K Gossett, RPH
• Luke Joseph Gotta, PA-C

• Addiction (Substance Use Disorder) Counselor in Fargo, ND
• Providers in Fargo, ND by specialty
• Addiction (Substance Use Disorder) Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.