Healthcare Provider Details

I. General information

NPI: 1912159427
Provider Name (Legal Business Name): JULIE HARDY L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 CLINTON ROAD
SEDALIA MO
65301-7917
US

IV. Provider business mailing address

P.O. BOX 147
GREEN RIDGE MO
65332
US

V. Phone/Fax

Practice location:
  • Phone: 660-829-1133
  • Fax: 660-829-1144
Mailing address:
  • Phone: 660-829-1133
  • Fax: 660-829-1144

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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number000968
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLC0989157
License Number StateMO

VIII. Authorized Official

Name: MRS. JULIE LENA HARDY
Title or Position: OWNER
Credential: LCSW
Phone: 660-829-1133