Healthcare Provider Details

I. General information

NPI: 1184909665
Provider Name (Legal Business Name): STEPHEN JARED HARDMAN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2011
Last Update Date: 12/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 CITY VIEW DR SUITE # 302
EVANSTON WY
82930-5327
US

IV. Provider business mailing address

1430 WILKINS CIR
CASPER WY
82601-1336
US

V. Phone/Fax

Practice location:
  • Phone: 307-789-7915
  • Fax: 307-789-6009
Mailing address:
  • Phone: 307-237-9583
  • Fax: 307-265-7277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC-1292
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: