MS. SUSAN RIDDLE GORDON (NPI# 1285678359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285678359 |
| Entity Type | Individual |
| Full Name | MS. SUSAN RIDDLE GORDON |
| Credential | LCSW |
| Practice Address |
2402 Tift Ave N Suite 102 Tifton GA 31794-1883 |
| Practice Telephone | 2293926600 |
| Practice Fax Number | 2293822181 |
| Mailing Telephone | 2293926600 |
| Mailing Fax Number | 2293822181 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2008-12-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CSW003185 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 486449509B | 05 | |
| GA | 486449509C | 05 | |
| GA | 486449509A | 05 | |
| GA | 486449509D | 05 |
| 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 |
| 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 |
| 1255657482 | Susan Gordon | Pharmacist | 5 Maple Rd, Voorheesville, NY 12186-9419 | 2010-04-13 |
| Street Address |
2402 TIFT AVE N SUITE 102 |
| City | TIFTON |
| State | GA |
| Zip Code | 31794-1883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598269334 | Travis Clark Hall | Counselor | 2402 Tift Ave N, Tifton, GA 31794-1883 | 2018-03-19 |
| 1992241400 | Bhg Xlv, LLC | Clinic/Center | 2402 Tift Ave N, Suite 202, Tifton, GA 31794-1883 | 2017-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234043 | Deloris Lunsford | Licensed Practical Nurse | 903 Washington St., Tifton, GA 31794 | 2020-01-17 |
| 1194383075 | William Jordan Kinnett | Registered Nurse | 1205 Tift Ave N, Tifton, GA 31794 | 2019-06-05 |
| 1598321200 | Courtlyn Christanna Fussell | Pharmacist | 2201 Hwy 41 N, Tifton, GA 31794 | 2019-05-17 |
| 1376027722 | Martha Gibbs | Nurse Practitioner | Affinity Clinic/west Campus, 2225 Us Hwy 41 North, Tifton, GA 31794 | 2018-09-21 |
| 1427541044 | Rebekah F Cottle | Speech-Language Pathologist | 2227 Highway 41 North, Tifton, GA 31794 | 2018-06-08 |
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1568975431 | Skyler Clark | Pharmacist | 2201 North 12th Street, Tifton, GA 31794 | 2017-11-14 |
| 1538606306 | Imagine Peace Counseling LLC | Counselor | 223 E 2nd Street, Suite B, Tifton, GA 31794 | 2017-01-31 |
| 1073056347 | Jessica Tumbling | Contractor | 219 Savannah Way, Tifton, GA 31794 | 2016-11-18 |
| 1992159503 | Joseph Thomas Seagraves Jr. | Nurse Practitioner | 901 East 18th Street, Tifton, GA 31794 | 2016-04-20 |
| Find all providers in zip 31794 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295277416 | Joshua Alexander White IIi | Social Worker | 340 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2016-11-07 |
| 1821176801 | Sujette Evitt Giddens | Social Worker | 334 Tifton Eldorado Road, Tifton, GA 31794 | 2006-11-01 |
| 1366467268 | Michele L Walker | Social Worker | 2402 North Tift Ave., Ste. 102 South Georgia Psychiatric and Counseling Cente, Tifton, GA 31794 | 2006-07-12 |
| 1043844418 | Amanda L Cofield | Social Worker | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2020-02-25 |
| 1790296879 | Jessica Kayla Purvis | Social Worker | 911 Main St S, Tifton, GA 31794-4867 | 2017-10-17 |
| 1245696582 | Walnut Hill Counseling Services LLC | Social Worker | 223 2nd St E, Suite B, Tifton, GA 31794-4493 | 2015-12-31 |
| 1437523859 | Aneisa Marie Young | Social Worker | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2015-11-23 |
| 1770967317 | Alexia Michelle Tanner | Social Worker | 911 Main St S, Tifton, GA 31794-4867 | 2015-07-14 |
| 1356778435 | Lee Michelle Brooks | Social Worker | 907 18th St E, Suite 150, Tifton, GA 31794-3643 | 2013-10-03 |
| 1891040051 | Kristy P Daniels | Social Worker | 2225 Us Highway 41 N, Tifton, GA 31794-2749 | 2012-07-13 |
| Find all providers in TIFTON | ||||
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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.