Melissa Lynn Gardner

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C1672 Issued in NV

Practice address

3925 N Martin Luther King #212
Las Vegas, NV 89032-7673

Phone

(702) 461-1982

NPI assigned

Apr 15, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566604800000",
    "number": "1336568641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 N MARTIN LUTHER KING #212",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890327673",
            "telephone_number": "702-461-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 N MARTIN LUTHER KING #212",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "890327673",
            "telephone_number": "702-461-1982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 Pinto Ln",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064019",
            "country_code": "US",
            "telephone_number": "702-816-3658",
            "fax_number": "702-816-4337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2019-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "C1672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336568641",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Robert Gardner, M.D.
• Kiante' Gardner, RBT
• Leah Gardner
• Mary Dean Gardner
• Melanie Gardner, SW
• Michael Gardner
• Michael See Gardner, FNP
• Mykela Lashanti Natalie Gardner
• Nichole Marie Gardner, ND
• Nicole Gardner

• Professional Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Professional Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.