Provider Demographics
NPI:1861550402
Name:GARDNER, KATHRYN D (LCPC, LMHC)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:D
Last Name:GARDNER
Suffix:
Gender:F
Credentials:LCPC, LMHC
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:D
Other - Last Name:MICHALSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:10329 CROSS CREEK BLVD STE N
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2994
Mailing Address - Country:US
Mailing Address - Phone:813-771-0888
Mailing Address - Fax:
Practice Address - Street 1:10329 CROSS CREEK BLVD STE N
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2994
Practice Address - Country:US
Practice Address - Phone:813-771-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23794101YP2500X
IL180.005469101YP2500X
IL180005469101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty