Jasmine Tierra Gordon, LCSW
Social Worker, Clinical in Zebulon, NC. Individual provider (NPI-1).
NPI number1891295960
StatusActive
Last updated in NPPESSep 15, 2023
Details
- NPI
- 1891295960
- Entity type
- Individual (NPI-1)
- Name
- Jasmine Tierra Gordon
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 15, 2018
- Certification date
- Sep 15, 2023
- Last updated
- Sep 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | C013048 | NC | Yes |
Practice location
709 Cider Mill WayZebulon, NC 27597-3311
Phone 984-289-8127
Mailing address
709 Cider Mill WayZebulon, NC 27597-3311
Phone 984-289-8127
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