Healthcare Provider Details

I. General information

NPI: 1417672577
Provider Name (Legal Business Name): AMANDA HARDY, PHD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

558 28TH ST
DES MOINES IA
50312-5222
US

IV. Provider business mailing address

558 28TH ST
DES MOINES IA
50312-5222
US

V. Phone/Fax

Practice location:
  • Phone: 515-218-9182
  • Fax:
Mailing address:
  • Phone: 515-218-9182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AMANDA HARDY
Title or Position: OWNER/COUNSELOR
Credential: LMHC, PMH-C
Phone: 515-218-9182