Michelle Lea Gordon, LPC
Individual provider Active NPI Professional Counselor · Crossnore, NC
NPI 1316150899 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1316150899
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 4760 (NC)
- Practice address
- 100 Dar Dr.
Crossnore, NC 28616-0249 - Phone
- (828) 733-4305
- Fax
- (828) 733-1704
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4760 | NC | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4760 | NC | Yes |
Addresses
Primary practice location
100 Dar Dr.
Crossnore, NC 28616-0249
Mailing address
PO Box 249
Crossnore, NC 28616-0249
Phone (828) 733-4305
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6102468 | Medicaid | NC |
Other providers in Crossnore, NC
- Zachary J Champion
- Crossnore Communities for Children
- Crossnore School Inc
- Crossnore School, Inc.
- Amanda Ruth Ferrell
- Isabelle Grace Hoke
- Katherine H Jones
- Shelby Jones
- Leigh Blake Kadans
- Pamela Carol Loven
All providers in Crossnore, NC · Professional Counselor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.