Aqualus Mondrell Gordon, PH.D.

Psychologist · Lees Summit, MO

Individual Active NPI

NPI number 1235729575

Practice location

1320 NE Windsor Dr
Lees Summit, MO 64086-8477
Phone
(816) 287-8959

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NPI record

NPI
1235729575
Entity type
Individual (Type 1)
Enumeration date
January 20, 2021
Last updated
January 20, 2021
Certified
January 20, 2021
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Psychologist Primary 103T00000X 2020017925 MO
Counseling Psychologist 103TC1900X 2020017925 MO

Mailing address

702 NE Westwind Dr
Lees Summit, MO 64086-5620
Phone
(512) 923-5328

About Dr. Gordon

Aqualus Mondrell Gordon, PH.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Psychologist (code 103T00000X). The practice location is 1320 NE Windsor Dr, Lees Summit, MO 64086-8477. The NPI number 1235729575 was assigned on January 20, 2021 and the record was last updated on January 20, 2021.

Dr. Gordon lists 2 licenses in the registry: #2020017925 (MO) for Psychologist; #2020017925 (MO) for Counseling Psychologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Aqualus Mondrell Gordon, PH.D.?

The NPI number is 1235729575.

What is the phone number of Dr. Gordon?

The phone number listed for the practice location is (816) 287-8959.

Where is Dr. Gordon located?

1320 NE Windsor Dr, Lees Summit, MO 64086-8477.

What is the taxonomy code for Dr. Gordon?

The primary taxonomy code is 103T00000X – Psychologist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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