Healthcare Provider Details

I. General information

NPI: 1033033816
Provider Name (Legal Business Name): ZAINA GORDON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 HARRISON BRIDGE RD
SIMPSONVILLE SC
29680-7004
US

IV. Provider business mailing address

270 GAYLE AVE NW
AIKEN SC
29801-4040
US

V. Phone/Fax

Practice location:
  • Phone: 864-272-0388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12232
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: