Healthcare Provider Details

I. General information

NPI: 1861906315
Provider Name (Legal Business Name): JAMIE ANNE HARDY LPC, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE ANNE EDWARDS

II. Dates (important events)

Enumeration Date: 11/20/2017
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9108 CHURCH ST # 308
MANASSAS VA
20110-5436
US

IV. Provider business mailing address

9108 CHURCH ST #308
MANASSAS VA
20110
US

V. Phone/Fax

Practice location:
  • Phone: 703-686-8728
  • Fax: 703-775-1458
Mailing address:
  • Phone: 703-686-8728
  • Fax: 703-775-1458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701007313
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: