MEDICARE: ELISSA HARDY LCSW

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
1	1041C0700X	Clinical Social Worker	523	CO

General Provider Information

NPI Number	:	1467527622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISSA HARDY LCSW

Provider Business Mailing Address
First Line	:	10 W 14TH AVENUE PKWY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-2749
Country	:	US
Telephone Number	:	720-865-3443
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 W 14TH AVENUE PKWY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-2749
Country	:	US
Telephone Number	:	720-865-3443
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	01/05/2016

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