ALICIA GORDON


Address: 132 Carol Cir, Fitzgerald, GA 31750-8128
Phone: 5612527261

ALICIA GORDON (NPI# 1285149955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285149955
Entity Type Individual
Full Name ALICIA GORDON
Credential LCSW
Practice Address 132 Carol Cir
Fitzgerald
GA 31750-8128
Mailing Address 5464 Club Cir
Haverhill
FL 33415-1262
Practice Telephone 5612527261
Mailing Telephone 5612527261
Enumeration Date 2017-12-04
Last Update Date 2020-11-09
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD1600X Clinic/Center
Specialization: Developmental Disabilities
FL Ambulatory Health Care Facilities

Provider Secondary Practice Location

Address Telephone Number Fax Number
5464 Club Cir, Haverhill, FL 334151262 5612527261 5612527261

Other Providers ALICIA GORDON

NPI Name Taxonomy Address Enumeration
1508490079 Alicia Gordon Physician Assistant 18901 Lake Shore Blvd, Euclid, OH 44119-1078 2020-02-24
1063758704 Alicia Gordon Physician Assistant 1201 Alhambra Blvd, #230, Sacramento, CA 95816-5238 2012-12-28
1700079860 Alicia Gordon Nurse's Aide 2250 Hickory Rd, Suite 240, Plymouth Meeting, PA 19462-1047 2007-08-22
1568524361 Alicia Gordon Dentist 1010 Murfreesboro Rd, Suite 196, Franklin, TN 37064-3000 2006-12-15

Office Location

Street Address 132 CAROL CIR
City FITZGERALD
State GA
Zip Code 31750-8128

Providers in the same location

NPI Name Taxonomy Address Enumeration
1750899829 Ag Counseling Case Management 132 Carol Cir, Fitzgerald, GA 31750-8128 2018-01-11

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1427662741 Rural Urgent Care LLC Clinic/Center 125 Benjamin H Hill Dr. Sw, Fitzgerald, GA 31750 2020-09-03
1730604943 Karen Denise Charles Rehabilitation Counselor 410 South Sherman Street, Fitzgerald, GA 31750 2017-08-08
1457898249 Walter Stone Nurse Practitioner 116 Norman Dorminy Dr, Ste 12, Dmc Physician Group LLC, Fitzgerald, GA 31750 2017-01-31
1013315605 Tift County Hospital Authority Family Medicine 246 Ben Hill Drive, Fitzgerald, GA 31750 2014-12-12
1881940211 We Care Transportation, LLC Non-emergency Medical Transport (VAN) 608 N Sherman St, Fitzgerald, GA 31750 2012-08-03
1922365501 Shayla Curtis Family Medicine 613 S Grant St, Fitzgerald, GA 31750 2012-04-19
1134380520 Winston C Ugbajah Family Medicine 116 Benjamin Hill Drive, Suite 12, Fitzgerald, GA 31750 2008-06-19
1306966791 Larry E Forth O D P C Optometrist 708 S Grant St, Suite #18, Fitzgerald, GA 31750 2007-03-30
1740370691 Thomas R Mann Internal Medicine 118 Norman Dorminy Drive, Fitzgerald, GA 31750 2006-10-13
1407865389 Jude Ogho Okugbeni Family Medicine 407 West Pine, Fitzgerald, GA 31750 2006-08-07
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Taxonomy Information

Taxonomy Code 261QD1600X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Developmental Disabilities

Taxonomy Definition

An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
Notes: [7/1/2003: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1922653534 Five Star Education Advocacy Group Inc Clinic/Center 978 Fellowship Rd, Fairburn, GA 30213-1789 2019-08-09
1205329687 Advantage Behavioral Health Systems Clinic/Center 638 Michael Cir., Monroe, GA 30655 2018-06-11
1215420690 Advantage Behavioral Health Systems Clinic/Center 1801 Prospect Rd., Madison, GA 30650 2018-06-11
1225567597 Vincentia Paul-constantin Clinic/Center 2867 Country House Lane, Buford, GA 30519 2017-06-08
1598158909 Musik To Grow Clinic/Center 1517 Johnson Ferry Rd, Marietta, GA 30062-6493 2015-03-09
1356692800 Ridgewood Personal Care Home, Inc Clinic/Center 1065 Murray Cir Sw, Marietta, GA 30064-3927 2012-09-24
1790055432 Trapeze Therapy, LLC Clinic/Center 160 Tracy St, Suite A, Athens, GA 30601-1979 2012-01-11
1326316274 Early/miller Day (now) Clinic/Center 302 Damacus Street, Blakely, GA 39823-3346 2011-12-07
1710255773 Early Miller Personal Support (now) Clinic/Center 302 Damascus Street, Blakely, GA 39823-3346 2011-12-06
1790052637 Terrell Lee (now) Clinic/Center 508 Oak St Se, Dawson, GA 39842-2024 2011-11-21
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Competitor

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City FITZGERALD
Zip Code 31750

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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