Provider Demographics
NPI:1427784701
Name:GORDON, BRITTANY DAWN (LAMFT, LMHC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:DAWN
Last Name:GORDON
Suffix:
Gender:F
Credentials:LAMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4273 MONTGOMERY BLVD NE STE K220
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6748
Mailing Address - Country:US
Mailing Address - Phone:055-541-2835
Mailing Address - Fax:
Practice Address - Street 1:4253 MONTGOMERY BLVD NE STE G130
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1106
Practice Address - Country:US
Practice Address - Phone:505-554-1283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2023-0872101YM0800X
NMCTB-2024-0060106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM56209754Medicaid