Individual provider · Type 1 NPI

James Allan Gardner, Jr., PHD LICSW

Clinical Social Worker · South Boston, MA

NPI number 1407819261 Active

Practice location

58 Old Colony Ave
South Boston, MA 02127-2406

Fax (617) 268-1991

Mailing address

221 Oak St, CB6
Brockton, MA 02301-1359

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X106952 (MA)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1407819261

James Allan Gardner, Jr., PHD LICSW's National Provider Identifier is 1407819261, issued on Apr 11, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in South Boston, MA. The record was last updated on Jul 13, 2026.