Healthcare Provider Details

I. General information

NPI: 1598669012
Provider Name (Legal Business Name): ELIZABETH GORDAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 VALLEY WAY
WEST ORANGE NJ
07052-5832
US

IV. Provider business mailing address

98 VALLEY WAY
WEST ORANGE NJ
07052-5832
US

V. Phone/Fax

Practice location:
  • Phone: 201-306-4183
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00240900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: