Andrea R Gardner-Young, LPC, CMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C5086 Issued in OR

Practice address

1995 Newmark Ave # 1017
Coos Bay, OR 97420-4727

NPI assigned

Aug 24, 2017

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

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": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1598282188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 N 8TH ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202416",
            "telephone_number": "801-259-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 NEWMARK AVE # 1017",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974204727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER-YOUNG",
        "first_name": "ANDREA",
        "middle_name": "R",
        "credential": "LPC, CMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "7403966-6004",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey G. Friedman, LCSW
• Brian G. Fuller, M.D.
• Amanda Banks Galer, MSW LCSW
• Jingzhe Gao, DNP-CRNA
• Susan Garcia, RD, LD
• Marissa Gardner
• Abel A. Garibaldi, M.D.
• Gregory Garrow, LCSW
• Patricia B Gates, OD
• Karie G Gederos, PHARMACY CPHT

• Mental Health Counselor in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.