MS. MIA EMILY GORDON (NPI# 1396183091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396183091 |
| Entity Type | Individual |
| Full Name | MS. MIA EMILY GORDON |
| Credential | LPC |
| Practice Address |
204 Executive Ct Ste 301 Little Rock AR 72205-4532 |
| Practice Telephone | 5016791469 |
| Mailing Telephone | 5016791469 |
| Mailing Fax Number | 6173790496 |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2020-03-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
A1305056 | AR | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
P1508084 | AR | Behavioral Health & Social Service Providers |
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 575 Club Ln Ste 103, Conway, AR 720343680 | 5014049737 | 6173790496 |
| Street Address |
204 EXECUTIVE CT STE 301 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72205-4532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932719465 | Darleisha Renee Stigall | Behavior Technician | 1210 Aldersdate Rd, Little Rock, AR 72205 | 2020-08-10 |
| 1316563638 | Unknown Amisha | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 | 2020-06-23 |
| 1225667272 | Ann-marie Frances Hayre | Student in an Organized Health Care Education/Training Program | 4310 West Markham, Slot 589, Little Rock, AR 72205 | 2020-04-02 |
| 1952930075 | Alexandria Leigh Smith | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot 531, Little Rock, AR 72205 | 2020-04-02 |
| 1093353922 | Phil Fagala | Pharmacist | 614 North Beechwood, Little Rock, AR 72205 | 2019-12-10 |
| 1295391688 | Home To Community Living, Inc | Physical Therapist | 10201 W Markham Street Pulaski, Little Rock, AR 72205 | 2019-05-12 |
| 1669933693 | Sandy Louise Webb | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 530, Little Rock, AR 72205 | 2019-03-31 |
| 1457812828 | Vincent Battafarano | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 602, Little Rock, AR 72205 | 2019-03-28 |
| 1063978922 | Franks Pediatric Occupational Therapy LLC | Occupational Therapist | 5516 C St, Little Rock, AR 72205 | 2019-02-15 |
| 1497210199 | Integrative Counseling Center LLC | Counselor | 10515 W Markham St Ste D3, Little Rock, AR 72205 | 2019-02-06 |
| Find all providers in zip 72205 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487290888 | John Hunter Bramlitt | Counselor | 12320 I-30, Little Rock, AR 72210 | 2019-11-20 |
| 1114562071 | Ariel Brown | Counselor | 10 Remington Dr, Little Rock, AR 72204-8202 | 2019-11-14 |
| 1972159267 | Arkansas Baptist Children's Homes and Family Ministries | Counselor | 12400 I-30, Little Rock, AR 72210 | 2019-08-13 |
| 1518526664 | James Wesley Johnson Jr. | Counselor | 415 N Mckinley St Ste 520, Little Rock, AR 72205-3175 | 2019-06-12 |
| 1497210199 | Integrative Counseling Center LLC | Counselor | 10515 W Markham St Ste D3, Little Rock, AR 72205 | 2019-02-06 |
| 1255886560 | Amelia H Lewis | Counselor | 12115 Hinson Rd Ste 400, Little Rock, AR 72212-3476 | 2016-08-17 |
| 1003234675 | Jill Gorman Lpc LLC | Counselor | 1501 N University Ave Ste 700, Little Rock, AR 72207-5297 | 2014-04-01 |
| 1780926857 | Ezekeil Kinchen | Counselor | 3804 W Charles Bussey Ave, 3804 W Chas Bussey Ave, Little Rock, AR 72204-3902 | 2013-03-26 |
| 1285979609 | Charles Richard Chamblee Jr. | Counselor | 11401 I-30, Little Rock, AR 72209-7042 | 2012-12-11 |
| 1992062996 | Whitney Norris | Counselor | 10800 Financial Ctr, #290, Little Rock, AR 72211 | 2012-04-13 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72205 |
Please comment or provide details below to improve the information on MS. MIA EMILY GORDON.
| 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.