MEDICARE: JANAE GARDNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	IMH24002	FL

General Provider Information

NPI Number	:	1235627381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANAE GARDNER

Provider Business Mailing Address
First Line	:	3447 W 63RD AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-2042
Country	:	US
Telephone Number	:	512-738-6396
Fax Number	:	303-364-9262

Provider Business Practice Location Address
First Line	:	3447 W 63RD AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-2042
Country	:	US
Telephone Number	:	512-738-6396
Fax Number	:	303-364-9262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2018
Last Update Date	:	07/16/2025

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Directions to “ JANAE GARDNER ” Practice Location

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