Provider Demographics
NPI:1952666232
Name:GARDNER, AARON F (MA, LPC, CMHC)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:F
Last Name:GARDNER
Suffix:
Gender:M
Credentials:MA, LPC, CMHC
Other - Prefix:MR
Other - First Name:FAY
Other - Middle Name:AARON
Other - Last Name:GARDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2800 S 1200 W
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-4226
Mailing Address - Country:US
Mailing Address - Phone:801-686-9334
Mailing Address - Fax:801-326-0225
Practice Address - Street 1:2800 S 1200 W
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:UT
Practice Address - Zip Code:84302-4226
Practice Address - Country:US
Practice Address - Phone:435-723-2881
Practice Address - Fax:435-734-2719
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT296354-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional