IndividualActive
Aqualus Gordon, PH.D.
NPI 1235729575 · Psychologist · Lees Summit, MO
Provider details
- NPI number
- 1235729575
- Entity type
- Individual
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 2020017925 (MO)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Practice location
1320 Ne Windsor Dr
Lees Summit, MO 64086-8477
Phone: (816) 287-8959
Approximate (ZIP-level) locationGet directions
Mailing address
702 Ne Westwind Dr
Lees Summit, MO 64086-5620
Registry dates
- Enumerated
- 2021-01-20
- Last updated
- 2021-01-20
- Certified
- 2021-01-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.