Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Colt Gordon, LCSW110973

Individual provider Clinical Social Worker · NPI 1538762471

Mr. Colt Gordon, LCSW110973 is a Clinical Social Worker in Cody, Wyoming. Works from 2 locations. Licensed in California and Wyoming.

Licensed in
CA, WY
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

627 15th St
Cody, WY 82414-3109
Phone: (619) 453-5063
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5101 Santa Monica Blvd, Los Angeles, CA 90029-2478 — (626) 539-3524

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 110973 (CA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 1577 (WY)

Record details

NPI number1538762471
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW110973
Sole proprietorNo
NPI enumeratedNovember 20, 2020
Last updated in NPPESJanuary 31, 2024
Certification dateJanuary 31, 2024

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