| Gordon Wellness Llc | |
|
610 Thimble Shoals Blvd # 403 Newport News VA 23606-2573 | |
| (757) 534-7840 | |
| (757) 506-0432 |
| Full Name | Gordon Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 610 Thimble Shoals Blvd # 403, Newport News, Virginia |
| Authorized Official Name and Position | Tonya Dorline Johnson (OWNER) |
| Authorized Official Contact | 7575347840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gordon Wellness Llc 610 Thimble Shoals Blvd 401-a Newport News VA 23606-2573 Ph: (757) 534-7840 | Gordon Wellness Llc 610 Thimble Shoals Blvd # 403 Newport News VA 23606-2573 Ph: (757) 534-7840 |
| NPI Number | 1376928101 |
|---|---|
| Provider Enumeration Date | 07/22/2015 |
| Last Update Date | 07/09/2024 |
| Certification Date | 07/09/2024 |
| Medicare PECOS PAC ID | 9638602899 |
|---|---|
| Medicare Enrollment ID | O20241025002147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376928101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 090400826 (Virginia) | Primary |
| Provider Name | Tonya Dorline Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750710232 PECOS PAC ID: 1456677053 Enrollment ID: I20150225001486 |
| Provider Name | Anthony Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700326634 PECOS PAC ID: 7618253683 Enrollment ID: I20170406001457 |
| Provider Name | Tamara Lynn Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588325872 PECOS PAC ID: 8628598430 Enrollment ID: I20250224003633 |
| Provider Name | Nadia Laszig Bender |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063173599 PECOS PAC ID: 3678095767 Enrollment ID: I20250318003011 |
| Provider Name | David Anthony Walter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417608001 PECOS PAC ID: 9234652173 Enrollment ID: I20250401001310 |
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