NPIMap

Individual provider Active NPI

Christine Renee Gardner, LCSW, LISW

  • Clinical Social Worker
  • Virgina Beach, VA
National Provider Identifier
1801830773
Registry record updated Feb 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904007527 Issued in VA
Practice address
256 North Witchduck Road
Suite G
Virgina Beach, VA 23462
Phone
(757) 693-2144
Fax
(574) 296-7560
NPI assigned
Jun 15, 2006
Last updated
Feb 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 34004406A IN
Clinical Social Worker 1041C0700X 0904007527 VA Primary
Clinical Social Worker 1041C0700X 34004406A IN
Clinical Social Worker 1041C0700X I9921 OH

Addresses

Primary practice location

256 North Witchduck Road
Suite G
Virgina Beach, VA 23462

Mailing address

5505 Larry Avenue
Virginia Beach, VA 23462
Phone (757) 693-2144

Other identifiers 1

IdentifierTypeStateIssuer
000000499506OtherINANTHEM BCBS #

Other names 1

  • Mrs. Christine Renee Kuhns Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
34004406AINMDSocial Worker
I9921OHMDClinical Social Worker
0904007527VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hearts Counseling CNTR Clinical Past Accepting new patients

Organizations & group practices 1

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1801830773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 LARRY AVENUE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23462",
            "telephone_number": "757-693-2144",
            "fax_number": "574-296-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 NORTH WITCHDUCK ROAD",
            "address_2": "SUITE G",
            "city": "VIRGINA BEACH",
            "state": "VA",
            "postal_code": "23462",
            "telephone_number": "757-693-2144",
            "fax_number": "574-296-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "CHRISTINE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "34004406A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007527",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004406A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I9921",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS #",
            "identifier": "000000499506",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "KUHNS",
            "middle_name": "RENEE",
            "prefix": "MRS.",
            "credential": "LCSW, LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Virgina Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; 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.