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NPI Code Detail

MEDICARE: MR. SAMUEL HARDER LPC, CADCIII

MEDICARE: MR. SAMUEL HARDER LPC, CADCIII
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorC496OR

General Provider Information

NPI Number : 1376977207
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SAMUEL HARDER LPC, CADCIII
Provider Business Mailing Address
First Line : 2577 NE COURTNEY DR
Second Line :
City : BEND
State : OR
Zip : 97701-7752
Country : US
Telephone Number : 541-322-7500
Fax Number :
Provider Business Practice Location Address
First Line : 406 W ANTLER AVE
Second Line :
City : REDMOND
State : OR
Zip : 97756-1812
Country : US
Telephone Number : 541-322-7500
Fax Number : 541-322-7565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2013
Last Update Date : 08/21/2019

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