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General NPI Number Information
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NPI Number | 1366195174
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Entity Type | Individual
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Provider Name | BELINDA GARDNER LMSW
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Gender | Female
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 644 N CHASE ST
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City | ATHENS
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State | GA
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Zip | 30601-1960
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Country | US
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Telephone | 229-800-9695
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27217
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City | MEMPHIS
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State | TN
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Zip | 38167-0217
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Country | US
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Telephone | 901-515-1262
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 12867
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | MSW011787
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License Number State | GA
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