NPI 1073604112

Mark Steven Gardner, LCSW

Practitioner Clinical Social Worker Mc Lean, VA

Practice location

Address: 1319 Vincent Pl, Mc Lean, VA 22101-3615
Phone: (703) 341-5995
Fax: (703) 341-5995

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence 0904005796 (VA)

Other Social Worker providers in Virginia →

Registry record

NPI: 1073604112
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Sep 2006
Record last updated: 17 Mar 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.