Individual
TESSA JEAN GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSWA, LCASA
Contact information
Practice address
120 COASTAL HORIZONS DR, SHALLOTTE, NC 28470-6094
(910) 754-4515
(910) 202-9966
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145
(910) 202-9966
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-27486
NC
1041C0700X
Clinical Social Worker
P016433
NC
Other
Enumeration date
06/21/2021
Last updated
07/07/2021
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