SUSAN THERESA GORDON (NPI# 1275729881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275729881 |
| Entity Type | Individual |
| Full Name | SUSAN THERESA GORDON |
| Credential | LADC |
| Practice Address |
4227 9th Ave Sw Fargo ND 58103-2018 |
| Mailing Address |
715 11th St N Moorhead MN 56560-2083 |
| Practice Telephone | 7012826561 |
| Mailing Telephone | 2182336398 |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2007-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
301445 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | LADC | 301445 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053761312 | Susan Lynn Gordon | Counselor | 1525 Martin Luther King Jr Way, Seattle, WA 98122-3129 | 2016-06-17 |
| 1730522913 | Susan M Gordon | Social Worker | 299 Little Bay Rd, Newington, NH 03801-2742 | 2013-04-08 |
| 1093901225 | Susan Leigh Gordon | Physical Therapist | 530 Highland Ave, Feasterville Trevose, PA 19053-6026 | 2007-09-21 |
| 1295952463 | Susan Ellen Gordon | Psychologist | 1 Darnall Hall, Washington, DC 20057-0001 | 2007-04-19 |
| 1447345657 | Susan Merle Gordon | Psychologist | 234 Bryn Mawr Avenue, Suite 202, Bryn Mawr, PA 19010 | 2006-10-04 |
| 1285678359 | Susan Riddle Gordon | Social Worker | 2402 Tift Ave N, Suite 102, Tifton, GA 31794-1883 | 2006-06-16 |
| 1376030122 | Susan Elizabeth Gordon | Counselor | 300 W 9th St, Frederick, MD 21701-4541 | 2018-04-17 |
| 1639531726 | Susan Gordon | Social Worker | 2233 Nostrand Ave, 2nd Fl., Brooklyn, NY 11210-3045 | 2016-03-28 |
| 1598199069 | Susan R Gordon | Physical Therapist | 600 N Robbins Rd Ste 101, Boise, ID 83702-4567 | 2013-09-02 |
| 1770804965 | Susan G. Gordon | Social Worker | 3020 Childrens Way # Mc5016, San Diego, CA 92123-4223 | 2010-06-22 |
| Street Address |
4227 9TH AVE SW |
| City | FARGO |
| State | ND |
| Zip Code | 58103-2018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699891648 | William P Sparke | Social Worker | 4227 9th Ave Sw, Fargo, ND 58103-2018 | 2007-03-21 |
| 1417316001 | Amber Nicole Mutalipassi | Social Worker | 4227 9th Ave Sw, Fargo, ND 58103-2018 | 2016-02-11 |
| 1891172540 | Molly Siegert | Counselor | 4227 9th Ave Sw, Fargo, ND 58103-2018 | 2015-05-01 |
| 1912348905 | Sadie Olson | Counselor | 4227 9th Ave Sw, Fargo, ND 58103-2018 | 2013-07-08 |
| 1992043038 | Jennifer A Tillisch | Counselor | 4227 9th Ave Sw, Fargo, ND 58103-2018 | 2013-01-24 |
| 1154670610 | Lisa Bartholomew Cameron | Counselor | 4227 9th Ave Sw, Fargo, ND 58103-2018 | 2012-08-30 |
| 1023316874 | Beth Louise Brantner | Counselor | 4227 9th Ave Sw, Fargo, ND 58103-2018 | 2011-03-03 |
| 1285874537 | Roberta R Nelson | Counselor | 4227 9th Ave Sw, Fargo, ND 58103-2018 | 2009-02-26 |
| 1063652543 | Steven D Gordon | Counselor | 4227 9th Ave Sw, Fargo, ND 58103-2018 | 2009-02-24 |
| 1710150099 | Orville S Mandan | Counselor | 4227 9th Ave Sw, Fargo, ND 58103-2018 | 2008-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991406 | N.i.a.m Brain Injury Services, LLP | Counselor | 1206 1st Ave S, Fargo, ND 58103-1747 | 2020-01-20 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1205360153 | Community Medical Services Montana-private, LLC | Counselor | 901 28th St S Ste B, Fargo, ND 58103-8743 | 2017-04-18 |
| 1962805317 | Lisa Vig | Counselor | 4720 7th Ave S Ste B, Fargo, ND 58103-7254 | 2014-09-30 |
| 1649689506 | Cara Christenson | Counselor | 505 40th St S, Suite B, Fargo, ND 58103-1184 | 2014-08-05 |
| 1215346259 | Stacey Nelson | Counselor | 4215 9th Ave S, Fargo, ND 58103-2018 | 2014-08-04 |
| 1508273418 | Robert Hansen | Counselor | 1202 23rd St S Ste 5, Fargo, ND 58103-2951 | 2014-07-14 |
| 1326469883 | Community Extended Nuclear Transitional Residence for Ex-offenders | Counselor | 123 15th St N, Fargo, ND 58102-4220 | 2013-12-30 |
| 1760765416 | Roberta J Pytlik | Counselor | 17 7th St S, Fargo, ND 58103-1800 | 2011-09-20 |
| 1891934873 | Paulette L Walker | Counselor | 1121 Westrac Dr S Ste 202, Fargo, ND 58103-2385 | 2009-02-13 |
| Find all providers in FARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.