Provider Demographics
NPI:1063119279
Name:GORDON, ALANA (MFTI, CCPS)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:GORDON
Suffix:
Gender:F
Credentials:MFTI, CCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 SKY POINTE DR STE 140-225
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-4043
Mailing Address - Country:US
Mailing Address - Phone:702-277-9145
Mailing Address - Fax:
Practice Address - Street 1:842 E 1400 S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:UT
Practice Address - Zip Code:84653-5311
Practice Address - Country:US
Practice Address - Phone:702-277-9145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI4058106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist