Wanda Kay Gordon McIntosh, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7804 Issued in CA

Practice address

5588 N Palm Ave # 10
Fresno, CA 93704

Phone

(559) 917-0991

Fax

(559) 650-5590

NPI assigned

Jul 2, 2007

Last updated

Aug 28, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Wanda K. McIntosh Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1578760526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5588 N PALM AVE # 10",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937041913",
            "telephone_number": "559-917-0991",
            "fax_number": "559-650-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5588 N PALM AVE # 10",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93704",
            "telephone_number": "559-917-0991",
            "fax_number": "559-650-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON MCINTOSH",
        "first_name": "WANDA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "7804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "MCINTOSH",
            "middle_name": "K.",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Gopal Reddy Gade M.D. Inc
• Ananth Gopalan, M.D
• Anu Gopalan, DO
• William Ray Gorden
• Karla Gordillo
• Jolie Marie Gordon-Browar, RN
• Kierra Shaunte Gordon-Smith
• Jacqueline Gordon, LPCC
• Doris W Gordy, P.A.
• Gorham Family Therapy, Inc (Townsend Therapy Services)

• Clinical Social Worker in Fresno, CA
• Providers in Fresno, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.