Healthcare Provider Details

I. General information

NPI: 1851086177
Provider Name (Legal Business Name): PATRICIA ELLEN HARDIN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8920 SOUTHPOINTE DR STE E1
INDIANAPOLIS IN
46227-7505
US

IV. Provider business mailing address

8205 E 56TH ST STE 200
INDIANAPOLIS IN
46216-1069
US

V. Phone/Fax

Practice location:
  • Phone: 317-851-1004
  • Fax: 317-386-7695
Mailing address:
  • Phone: 812-247-8010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39004362A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: