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General NPI Number Information
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NPI Number | 1023480415
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Entity Type | Individual
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Provider Name | SHAWNTA GARDENER LPC
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Gender | Female
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Dates
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Enumeration Date | 10/23/2015
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 1901 MANHATTAN BLVD BLDG D
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City | HARVEY
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State | LA
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Zip | 70058-3583
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Country | US
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Telephone | 504-913-4062
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Fax | 504-814-7982
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Provider Business Mailing Address
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Address Line | 3832 LIRO LN
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City | HARVEY
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State | LA
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Zip | 70058-1965
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Country | US
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Telephone | 504-913-8098
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6710
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License Number State | LA
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