Individual
MR. JAMES WILLIAM GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LCPC,CADC
Contact information
Practice address
2120 SCHEEL ST APT D, BELLEVILLE, IL 62221-4182
(217) 454-0192
Mailing address
2120 SCHEEL ST APT D, BELLEVILLE, IL 62221-4182
(217) 454-0192
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
178004025
IL
101YM0800X
Mental Health Counselor
Primary
178004025
IL
Other
Enumeration date
05/02/2007
Last updated
04/28/2017
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