MEDICARE: ALANA SAMANTHA GORDEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	22040	OK
2	1041C0700X	Clinical Social Worker	121015	MA

General Provider Information

NPI Number	:	1568845931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALANA SAMANTHA GORDEN

Provider Business Mailing Address
First Line	:	101 N GREENWOOD AVE STE 101
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74120-1444
Country	:	US
Telephone Number	:	321-696-9599
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 N GREENWOOD AVE STE 101
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74120-1444
Country	:	US
Telephone Number	:	321-696-9599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2015
Last Update Date	:	12/09/2025

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Directions to “ ALANA SAMANTHA GORDEN ” Practice Location

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