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General NPI Number Information
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NPI Number | 1427486331
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Entity Type | Individual
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Provider Name | KIMBERLEY MICHELLE HARDY LPC
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Gender | Female
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Dates
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Enumeration Date | 10/31/2013
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 1800 DIAGONAL RD STE 600
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2840
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Country | US
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Telephone | 440-444-7140
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 DIAGONAL RD STE 600
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2840
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Country | US
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Telephone | 440-444-7140
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.0900521
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701010368
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC11465
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License Number State | MD
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