Provider Demographics
NPI:1366695686
Name:GORDON, CHRISTINE LEIGH (LPC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LEIGH
Last Name:GORDON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 WEST LOOCKERMAN STREET
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-7325
Mailing Address - Country:US
Mailing Address - Phone:302-674-1397
Mailing Address - Fax:302-674-1602
Practice Address - Street 1:121 WEST LOOCKERMAN STREET
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-7325
Practice Address - Country:US
Practice Address - Phone:302-674-1397
Practice Address - Fax:302-674-1602
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC0000358101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional