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General NPI Number Information
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NPI Number | 1073250544
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Entity Type | Individual
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Provider Name | ANDREW PAUL GORDON MSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 05/17/2022
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1433 N WATER ST FL 4
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City | MILWAUKEE
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State | WI
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Zip | 53202-2557
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Country | US
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Telephone | 646-453-6777
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Fax |
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Provider Business Mailing Address
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Address Line | 2720 E ELIZABETH AVE
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City | SAINT FRANCIS
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State | WI
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Zip | 53235-4220
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Country | US
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Telephone | 414-882-3304
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12686-123
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License Number State | WI
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