Individual provider Active NPI

Brenda S Gardner, LPC

  • Mental Health Counselor
  • Midlothian, VA
National Provider Identifier
1053083246
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701010878 Issued in VA
Practice address
5309 Commonwealth Centre Pkwy Ste 401
Midlothian, VA 23112-2633
Phone
(804) 594-3690
NPI assigned
Oct 5, 2021
Last updated
Feb 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 0701010878 VA Primary

Addresses

Primary practice location

5309 Commonwealth Centre Pkwy Ste 401
Midlothian, VA 23112-2633

Mailing address

4415 Cara Hill LN
Chester, VA 23831-6816
Phone (804) 467-5176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240129000137 VA Practitioner - Mental Health Counselor 1254784010 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701010878VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Counseling Services LLC Multi-Specialty CurrentSince Oct 22, 2024 Accepting new patients
Balance Behavioral Health, PLLC Multi-Specialty CurrentSince Jan 8, 2024 Accepting new patients
Ephratah Health Group LLC Multi-Specialty PastSince Dec 1, 2025 Accepting new patients
Advanced Behavioral Health Services, LLC Multi-Specialty PastSince Oct 1, 2021 Accepting new patients

Locations

5309 Commonwealth Centre Pkwy
Midlothian, VA 23112
Phone (804) 545-7560

5309 Commonwealth Centre Pkwy
#P
Midlothian, VA 23112
Phone (804) 886-9188

5309 Commonwealth Centre Pkwy
Ste 104
Midlothian, VA 23112

5309 Commonwealth Centre Pkwy
Ste 401
Midlothian, VA 23112
Phone (804) 465-9311

6500 Woodlake Village Cir
Midlothian, VA 23112
Phone (804) 501-9567

6504 Woodlake Village Cir
Midlothian, VA 23112
Phone (804) 601-3653

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1053083246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 CARA HILL LN",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238316816",
            "telephone_number": "804-467-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5309 COMMONWEALTH CENTRE PKWY STE 401",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122633",
            "telephone_number": "804-594-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "BRENDA",
        "middle_name": "S",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-05",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701010878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.