ALICIA GORDON (NPI# 1285149955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
FL | Ambulatory Health Care Facilities |
Address | Telephone Number | Fax Number |
---|---|---|
5464 Club Cir, Haverhill, FL 334151262 | 5612527261 | 5612527261 |
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 |
Street Address |
132 CAROL CIR |
City | FITZGERALD |
State | GA |
Zip Code | 31750-8128 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750899829 | Ag Counseling | Case Management | 132 Carol Cir, Fitzgerald, GA 31750-8128 | 2018-01-11 |
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 |
Find all providers in zip 31750 |
Taxonomy Code | 261QD1600X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Developmental Disabilities |
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] |
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 |
Find all providers with the same taxonomy |
City | FITZGERALD |
Zip Code | 31750 |
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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.