Active NPI
Justin Rhea Gardner, LCDC
- Addiction (Substance Use Disorder) Counselor
- Dallas, TX
National Provider Identifier
1346068376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 17088
- Practice address
- 17101 Preston Rd Ste 110
Dallas, TX 75248-1374 - Phone
- (972) 250-1700
- NPI assigned
- Sep 30, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 17088 | TX | Primary |
| Mental Health Counselor | 101YM0800X | 17088 | TX |
Addresses
Primary practice location
17101 Preston Rd Ste 110
Dallas, TX 75248-1374
Mailing address
1424 Elizabeth St
Anna, TX 75409-8233
Phone (214) 663-1585
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17088 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784332800000",
"number": "1346068376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1424 ELIZABETH ST",
"city": "ANNA",
"state": "TX",
"postal_code": "754098233",
"telephone_number": "214-663-1585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17101 PRESTON RD STE 110",
"city": "DALLAS",
"state": "TX",
"postal_code": "752481374",
"telephone_number": "972-250-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "JUSTIN",
"middle_name": "RHEA",
"credential": "LCDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-30",
"last_updated": "2026-07-18",
"certification_date": "2026-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "17088",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "17088",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.