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General NPI Number Information
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NPI Number | 1730522913
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Entity Type | Individual
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Provider Name | SUSAN M GORDON LICSW
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Gender | Female
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Dates
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Enumeration Date | 04/08/2013
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 330 PORTSMOUTH AVE
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City | GREENLAND
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State | NH
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Zip | 03840-2220
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Country | US
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Telephone | 603-207-2197
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Fax | 603-377-8425
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Provider Business Mailing Address
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Address Line | 609 PORTSMOUTH AVE # 304
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City | GREENLAND
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State | NH
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Zip | 03840-9998
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Country | US
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Telephone | 603-207-2197
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Fax | 603-377-8425
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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 | 1675
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License Number State | NH
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