William Henry Gardner, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

413 Issued in NM

Practice address

3405 Pan American Fwy NE
Albuquerque, NM 87107-4786

Phone

(505) 222-0375

Fax

(505) 222-0301

NPI assigned

Sep 18, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• NM Department of Health

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Albuquerque, NM
  • NPI 1407990500
  NPD (past)

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

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253232000000",
    "number": "1942534201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 PAN AMERICAN FWY NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074786",
            "telephone_number": "505-222-0375",
            "fax_number": "505-222-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 PAN AMERICAN FWY NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074786",
            "telephone_number": "505-222-0375",
            "fax_number": "505-222-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "WILLIAM",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-18",
        "last_updated": "2009-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NM",
            "license": "413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie C Gardner, MD
• Stephen Scott Gardner, D.C.
• Suzanna Gardner, MS CCC-SLP
• Tamara Joy Gardner, CNP, CNM
• William C Gardner, DDS
• Richard Leroy Garduno, PTA
• Pamela Garfield, CNP, PMHNP
• Ishan Garg, MD
• Stephanie Garibay
• Linda Gariboldi

• Clinical Child & Adolescent Psychologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Child & Adolescent Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; 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.