Provider Demographics
NPI:1639909518
Name:GARDNER, DARNELL WILLIAM (MSW)
Entity type:Individual
Prefix:
First Name:DARNELL
Middle Name:WILLIAM
Last Name:GARDNER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9550 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-4664
Mailing Address - Country:US
Mailing Address - Phone:727-494-7609
Mailing Address - Fax:
Practice Address - Street 1:6563 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-6003
Practice Address - Country:US
Practice Address - Phone:727-380-9181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health