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NPI Code Detail

MEDICARE: ANGELA EVELYN GARDNER LCSW

MEDICARE: ANGELA EVELYN GARDNER LCSW
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
11041C0700XClinical Social WorkerBBH-LCSW-LIC-42766MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689214090
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA EVELYN GARDNER LCSW
Provider Business Mailing Address
First Line : 1444 BENJAMIN BLVD
Second Line :
City : BILLINGS
State : MT
Zip : 59105-5458
Country : US
Telephone Number : 406-839-3014
Fax Number :
Provider Business Practice Location Address
First Line : 902 WYOMING AVE
Second Line :
City : BILLINGS
State : MT
Zip : 59101-1637
Country : US
Telephone Number : 406-839-3014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2020
Last Update Date : 07/27/2021

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