Healthcare Provider Details

I. General information

NPI: 1477410140
Provider Name (Legal Business Name): GARRETT CHRISTIAN PARDOE NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 S HWY 27 STE 205
CLERMONT FL
34711-8067
US

IV. Provider business mailing address

2901 CR 776
WEBSTER FL
33597-5119
US

V. Phone/Fax

Practice location:
  • Phone: 407-949-0214
  • Fax:
Mailing address:
  • Phone: 410-599-4282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH26032
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: