Individual provider Active NPI

Anthony James Gardiner, LPC-S

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1922803436
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3979 Issued in AL
Practice address
3728 Philips Hwy Ste 31
Jacksonville, FL 32207-6840
Phone
(904) 399-8351
Fax
(904) 399-8355
NPI assigned
Feb 18, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3979 AL Primary

Addresses

Primary practice location

3728 Philips Hwy Ste 31
Jacksonville, FL 32207-6840

Mailing address

3728 Philips Hwy Ste 31
Jacksonville, FL 32207-6840
Phone (904) 399-8351

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

LicenseStateTypeSpecialty
3979ALMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1922803436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3728 PHILIPS HWY STE 31",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322076840",
            "telephone_number": "904-399-8351",
            "fax_number": "904-399-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3728 PHILIPS HWY STE 31",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322076840",
            "telephone_number": "904-399-8351",
            "fax_number": "904-399-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "credential": "LPC-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "3979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.