Active NPI
Carol Irene Gardner, LPC
- Professional Counselor
- Amarillo, TX
National Provider Identifier
1841279452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 13496
- Practice address
- 1711 S Polk St
Amarillo, TX 79102-3152 - Phone
- (806) 354-0727
- Fax
- (806) 354-0011
- NPI assigned
- Jan 11, 2006
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 13496 | TX | Primary |
Addresses
Primary practice location
1711 S Polk St
Amarillo, TX 79102-3152
Mailing address
1711 S Polk St
Amarillo, TX 79102-3152
Phone (806) 354-0727
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0956039-03 | Other | TX | TPMHMR MEDICAID LEGACY |
| 0956039-02 | Medicaid | TX | |
| 3230LC | Other | TX | BLUE CROSS/BLUE SHIELD |
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 |
|---|---|---|---|
| 13496 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189036800000",
"number": "1841279452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1711 S POLK ST",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791023152",
"telephone_number": "806-354-0727",
"fax_number": "806-354-0011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1711 S POLK ST",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791023152",
"telephone_number": "806-354-0727",
"fax_number": "806-354-0011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "CAROL",
"middle_name": "IRENE",
"name_prefix": "Dr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-11",
"last_updated": "2007-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "13496",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TPMHMR MEDICAID LEGACY",
"identifier": "0956039-03",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0956039-02",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "3230LC",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.