Provider Demographics
NPI:1558309179
Name:GAZDIK, CHRISTOPHER ANTHONY (MSW, ATOD, LCSW)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ANTHONY
Last Name:GAZDIK
Suffix:
Gender:M
Credentials:MSW, ATOD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 SPRUCE ST
Mailing Address - Street 2:SUITE 315
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-3385
Mailing Address - Country:US
Mailing Address - Phone:704-461-8253
Mailing Address - Fax:704-461-8267
Practice Address - Street 1:1212 SPRUCE ST
Practice Address - Street 2:SUITE 315
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3385
Practice Address - Country:US
Practice Address - Phone:704-461-8253
Practice Address - Fax:704-461-8253
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0034551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical