Healthcare Provider Details

I. General information

NPI: 1033763768
Provider Name (Legal Business Name): DELMAR DONTE HARDIN LCDC III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 09/11/2025
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1765 E WATERFORD CT APT 1013
AKRON OH
44313-8383
US

IV. Provider business mailing address

1765 E WATERFORD CT APT 1013
AKRON OH
44313-8383
US

V. Phone/Fax

Practice location:
  • Phone: 330-814-6681
  • Fax: 330-996-2233
Mailing address:
  • Phone: 330-814-6681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA167935
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: