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General NPI Number Information
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NPI Number | 1477449734
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Entity Type | Organization
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Legal Business Name | LISA GORDNER LCSW PLLC
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Dates
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Enumeration Date | 06/14/2025
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Last Update Date | 06/14/2025
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Provider Practice Location Address
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Address Line | 5297 PARKSIDE DR STE 306A
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City | CANANDAIGUA
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State | NY
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Zip | 14424-7504
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Country | US
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Telephone | 412-874-7659
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Fax | 412-874-7659
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Provider Business Mailing Address
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Address Line | 5297 PARKSIDE DR STE 306A
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City | CANANDAIGUA
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State | NY
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Zip | 14424-7504
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Country | US
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Telephone | 412-874-7659
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Fax | 412-874-7659
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Authorized Official
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Title or Position | OWNER
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Name | LISA M GORDNER
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Credential | LCSW
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Telephone | 412-874-7659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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