MR. GORDON LANE FAISON (NPI# 1710192935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710192935 |
| Entity Type | Individual |
| Full Name | MR. GORDON LANE FAISON |
| Credential | NA LCMHC |
| Practice Address |
54 Harris Place Brattleboro VT 05301 |
| Mailing Address |
Po Box 6262 Brattleboro VT 05302 |
| Practice Telephone | 8023800695 |
| Mailing Telephone | 8023800695 |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
068-0000321 | VT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 1008170 | 05 |
| Street Address |
54 HARRIS PLACE |
| City | BRATTLEBORO |
| State | VT |
| Zip Code | 05301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447276746 | Diane Leardi | Social Worker | 54 Harris Place, #202, Brattleboro, VT 05301 | 2006-07-14 |
| 1952323933 | Nancy M Kale | Social Worker | 54 Harris Place, Brattleboro, VT 05301-7127 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013575372 | Roberta M. White | Psychologist | 72 Whetstone Rd, Brattleboro, VT 05301 | 2019-06-03 |
| 1225526940 | Audrey Johnston | Nurse Practitioner | Brattleboro Family Medicine, 53 Fairview Street, Brattleboro, VT 05301 | 2018-04-27 |
| 1811349582 | Jillian Barney | Physician Assistant | 17 Belmont Ave Richards Building (1st Floor), Barttleboro, VT 05301 | 2016-07-06 |
| 1326413899 | Gabriella Neacsu Katz | Nurse Practitioner | 1860 Weatherhead Hollow Rd, Guilford, VT 05301 | 2015-12-09 |
| 1942608914 | Kathryn Peterson | Registered Nurse | 105 Winter St Apt 2, Brattleboro, VT 05301 | 2014-12-08 |
| 1558762823 | Saryn T Lauzon | Registered Nurse | 2 Maplewood Drive, Brattleboro, VT 05301 | 2014-09-05 |
| 1912248691 | Robert Joseph Stack | Counselor | 1 Linden Street, Brattleboro, VT 05301 | 2013-03-06 |
| 1053651760 | Christopher M. Deszynski | Naturopath | 73 Main St Ste 4, Brattleboro, VT 05301 | 2013-02-18 |
| 1518236355 | Christine Hamrin | Licensed Practical Nurse | 54 Spruce Street, Brattleboro, VT 05301 | 2011-12-23 |
| 1881924934 | Margrit C. Mikulis | Naturopath | 147 Orchard St, Brattleboro, VT 05301 | 2010-01-12 |
| Find all providers in zip 05301 | ||||
| Taxonomy Code | 103TP2701X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Group Psychotherapy |
| Definition to come... |
| Notes: [1/1/2007: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669771655 | Michael C. Gigante | Psychologist | 31 Frog Hl, Brattleboro, VT 05301-4410 | 2011-03-16 |
| 1902340029 | Allan Steinberg | Psychologist | 73 Main St, Suite # 3, Brattleboro, VT 05301 | 2016-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861609497 | Leona Phyllis Brown | Psychologist | 134 Rockingham Street, Bellows Falls, VT 05101 | 2007-05-16 |
| 1699891671 | Douglas Alan Flint | Psychologist | 494 Highland Ave Ste B, Newport, VT 05855-4912 | 2007-03-22 |
| 1184827123 | Alice D Outwater | Psychologist | 110 Main Street, Burlington, VT 05401-8451 | 2007-06-07 |
| 1174602445 | Patty Andrea Krasner | Psychologist | 94 Main Street, Putney, VT 05346 | 2006-11-06 |
| City | BRATTLEBORO |
| Zip Code | 05301 |
Please comment or provide details below to improve the information on MR. GORDON LANE FAISON.
| 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.