Individual provider · Type 1 NPI

Wade Gordon, LCSW

Clinical Social Worker · Rexburg, ID

NPI number 1376740134 Active

Practice location

310 N 2nd E, Suite 128
Rexburg, ID 83440-1600

Fax (208) 356-5675

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XLCSW-27205 (ID)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1376740134

Wade Gordon, LCSW's National Provider Identifier is 1376740134, issued on Jun 27, 2007. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Rexburg, ID. The record was last updated on Jul 8, 2007.