Gordon, Jaclyn
Gordon, Jaclyn is an sole proprietor health care provider with primary practice located at 42 Illinois Ave , Long Beach NY 11561-1112. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gordon, Jaclyn can be contacted via phone (347) 559-5694.Contact Information
Primary practice address
42 Illinois Ave
Long Beach NY 11561-1112
Phone: (347) 559-5694
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 026039 | New York |
Profile Details
| NPI number | 1285487504 |
|---|---|
| LBN Legal business name | Gordon, Jaclyn |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 8th, 2024 |
| Last updated | Jan 20th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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