Healthcare Provider Details

I. General information

NPI: 1992187819
Provider Name (Legal Business Name): ELIZABETH DUCEY-HARDOS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2015
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5435 ERICSON WAY STE 1
ARCATA CA
95521-9294
US

IV. Provider business mailing address

PO BOX 131
FORTUNA CA
95540-0131
US

V. Phone/Fax

Practice location:
  • Phone: 323-798-7413
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number115887
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: