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NPI Code Detail

MEDICARE: CAROLINE GORDON

MEDICARE: CAROLINE GORDON
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
1101YM0800XMental Health CounselorMA

General Provider Information

NPI Number : 1578411294
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINE GORDON
Provider Business Mailing Address
First Line : 53 TRAILSIDE LN
Second Line :
City : HANOVER
State : MA
Zip : 02339-2848
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 61 INDUSTRIAL PARK RD
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-7246
Country : US
Telephone Number : 508-927-1120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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Directions to “ CAROLINE GORDON ” Practice Location

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