Healthcare Provider Details

I. General information

NPI: 1285705756
Provider Name (Legal Business Name): LINDA K HARDY MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 AVENUE B
MARRERO LA
70072-3818
US

IV. Provider business mailing address

1432 AVENUE B
MARRERO LA
70072-3818
US

V. Phone/Fax

Practice location:
  • Phone: 615-645-2296
  • Fax:
Mailing address:
  • Phone: 615-319-6708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC0000001706
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: