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Individual

JASON R GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSCSW

Contact information

Practice address
2601 SW 3RD ST UNIT 1A, TOPEKA, KS 66606-2438
(785) 270-4630
(785) 270-4628
Mailing address
2601 SW 3RD ST UNIT 1A, TOPEKA, KS 66606-2438
(785) 270-4630
(785) 270-4628

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4419
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110661021
MEDICARE PTAN
KS
05
200962210B
KS
Enumeration date
07/09/2012
Last updated
12/16/2025
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