ICERICA GARDNER
NPI 1295460509
Counselor - Mental Health in Hattiesburg, MS

Active since July 20, 2022
110 PATTON AVE, HATTIESBURG, MS 39401(601) 582-1111(601) 450-0765 Get Directions Write a Review

NPPES record last updated: July 20, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Icerica Gardner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ICERICA GARDNER (NPI 1295460509) is an individual mental health provider in Hattiesburg, Mississippi, licensed in Mississippi (4967) and active in the NPI registry since July 2022.

NPPES Registry Identity

NPI1295460509
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameICERICA GARDNER
Location Address110 PATTON AVEHattiesburg, MS 39401-6155
Mailing AddressPo Box 18679Hattiesburg, MS 39404-8679 · (601) 705-1901
Fax(601) 450-0765
Sole ProprietorNo
Enumeration DateJuly 20, 2022
NPPES CertifiedJuly 20, 2022
NPI 1295460509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License Licensed in MS · 4967
110 PATTON AVE, Hattiesburg, MS 39401

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor
110 PATTON AVE
HATTIESBURG, MS 39401
Counselor (Professional)
110 PATTON AVE
HATTIESBURG, MS 39401
Social Worker
110 PATTON AVE
HATTIESBURG, MS 39401
Registered Nurse
110 PATTON AVE
HATTIESBURG, MS 39401
Counselor (Mental Health)
110 PATTON AVE
HATTIESBURG, MS 39401
Counselor
110 PATTON AVE
HATTIESBURG, MS 39401
Counselor
110 PATTON AVE
HATTIESBURG, MS 39401
Social Worker (Clinical)
110 PATTON AVE
HATTIESBURG, MS 39401

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Icerica Gardner's NPI number?

The NPI number for Icerica Gardner is 1295460509. It was assigned to this individual provider in the NPPES registry on July 20, 2022.

Where is Icerica Gardner located?

Icerica Gardner practices at 110 Patton Ave, Hattiesburg, MS 39401. The listed phone number is (601) 582-1111.

What is Icerica Gardner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Icerica Gardner was last updated on July 20, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.