Healthcare Provider Details

I. General information

NPI: 1831690684
Provider Name (Legal Business Name): LORI ELLEN GARDNER LPC NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2018
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 CREEKSIDE CT
HELENA AL
35080-3286
US

IV. Provider business mailing address

511 CREEKSIDE CT
HELENA AL
35080-3286
US

V. Phone/Fax

Practice location:
  • Phone: 205-202-9685
  • Fax:
Mailing address:
  • Phone: 813-924-2279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC3027A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: