Provider Demographics
NPI:1588696561
Name:GORDON-WEEKES, MARCIA (LCSW-R)
Entity type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:
Last Name:GORDON-WEEKES
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MRS
Other - First Name:MARCIA
Other - Middle Name:
Other - Last Name:GORDON-DUELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:2937 LURTING AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-4015
Mailing Address - Country:US
Mailing Address - Phone:718-231-1609
Mailing Address - Fax:
Practice Address - Street 1:2937 LURTING AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-4015
Practice Address - Country:US
Practice Address - Phone:718-231-1609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0209351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical