Daresa Gordon
Lactation Consultant, Non-RN in Manchester, Connecticut
1053260208- Practice location
- 38 Cone St, Manchester, CT 06040-4450
- Phone
- 860-478-5343
- Fax
- —
- Last updated
- January 22, 2026
Daresa Gordon is a Lactation Consultant, Non-RN based in Manchester, CT. Daresa Gordon practices in Manchester, CT. The NPI Number for Daresa Gordon is 1053260208 and holds a License No. 028566 (CT). The current practice location address for Daresa Gordon is 38 Cone St, Manchester, CT 06040-4450 and can be reached out via phone at 860-478-5343.
Provider Profile Details
- NPI Number
- 1053260208
- Provider Name
- Daresa Gordon
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 38 Cone St, Manchester, CT 06040-4450
- Phone Number
- 860-478-5343
- Primary Taxonomy
- Lactation Consultant, Non-RN · 174N00000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- January 22, 2026
- Last Update Date
- January 22, 2026
- Certification Date
- January 22, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 38 Cone St
Manchester, CT 06040-4450 - City
- Manchester
- State
- Connecticut
- Zip
- 06040-4450
- Phone Number
- 860-478-5343
Provider Business Mailing Address Details
- Address
- 38 Cone St
Manchester, CT 06040-4450 - City
- Manchester
- State
- CT
- Zip
- 06040-4450
- Phone Number
- 860-478-5343
License Information
- License Number (1)
- 028566
- License State (1)
- CT
- Taxonomy (1)
- Licensed Practical Nurse · 164W00000X
- License State (2)
- CT
- Taxonomy (2)
- Lactation Consultant, Non-RN · 174N00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Daresa Gordon?
The NPI number of Daresa Gordon is 1053260208. It was assigned on January 22, 2026 and is currently active in the NPPES registry.
What is the specialty of Daresa Gordon?
Daresa Gordon is registered under the primary taxonomy Lactation Consultant, Non-RN (code 174N00000X), licensed in CT under license number 028566.
Where does Daresa Gordon practice?
The practice location is 38 Cone St, Manchester, CT 06040-4450. The office can be reached at 860-478-5343 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1053260208 directly on the NPPES registry website.