Healthcare Provider Details

I. General information

NPI: 1821859471
Provider Name (Legal Business Name): KAYLA ANN GARDNER LPC, LPAT, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 W BROAD ST
COLUMBUS OH
43223-1297
US

IV. Provider business mailing address

3516 COVE LAKE LN
GROVE CITY OH
43123-4797
US

V. Phone/Fax

Practice location:
  • Phone: 614-754-0333
  • Fax:
Mailing address:
  • Phone: 614-441-1342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.1091706
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberART.24000038
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: