Individual ProviderMaryann GordonSocial WorkerBehavioral Health & Social Service ProvidersPractice Address144 Main St, Port Washington, NY 11050-2846(516) 650-3509PECOS EnrollmentBased on the most recent information from CMS, provider Maryann Gordon does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1801992250Provider TypeIndividualFull NameGordon, MaryannCredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date9/15/2006Last Updated10/27/2016Contact InformationPractice LocationPractice Address144 Main St, Port Washington, NY 11050-2846Phone(516) 650-3509FaxUnlisted FaxMailing LocationMailing Address144 Main St, Port Washington, NY 11050-2846Phone(516) 650-3509FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseR046235New York