Active NPI
Courtney Gardner, LCSW-C, LICSW
- Clinical Social Worker
- Bethesda, MD
National Provider Identifier
1609528587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16731
- Practice address
- 5315 Duvall Dr
Bethesda, MD 20816-1873 - Phone
- (202) 255-8514
- NPI assigned
- Jan 22, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 16731 | MD | Primary |
Addresses
Primary practice location
5315 Duvall Dr
Bethesda, MD 20816-1873
Mailing address
5315 Duvall Dr
Bethesda, MD 20816-1873
Phone (202) 255-8514
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000000 | Other | SOLE PRACTICE |
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 |
|---|---|---|---|
| 16731 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642809600000",
"number": "1609528587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5315 DUVALL DR",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208161873",
"telephone_number": "202-255-8514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5315 DUVALL DR",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208161873",
"telephone_number": "202-255-8514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "COURTNEY",
"credential": "LCSW-C, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-22",
"last_updated": "2022-01-22",
"certification_date": "2022-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "16731",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOLE PRACTICE",
"identifier": "000000000",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.