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NPI Code Detail

MEDICARE: BIANCA MERCEDES GORDON LMSW

MEDICARE:   BIANCA MERCEDES GORDON  LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerLMSW-19596AZ

General Provider Information

NPI Number : 1215786553
Entity Type Code : Individual
Provider Name (Legal Business Name) : BIANCA MERCEDES GORDON LMSW
Provider Business Mailing Address
First Line : 635 S ELLIS ST APT 3020
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-4974
Country : US
Telephone Number : 623-261-7983
Fax Number :
Provider Business Practice Location Address
First Line : 3377 S PRICE RD STE 103
Second Line :
City : CHANDLER
State : AZ
Zip : 85248-3573
Country : US
Telephone Number : 480-252-5152
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2024
Last Update Date : 12/03/2025

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Directions to “ BIANCA MERCEDES GORDON LMSW” Practice Location

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