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NPI Code Detail

MEDICARE: MRS. MARY JO HARDICK LCSW, LMFT

MEDICARE: MRS. MARY JO HARDICK LCSW, LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCW-003973-LPA
2106H00000XMarriage & Family TherapistMF-0000-88PA

General Provider Information

NPI Number : 1225037278
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY JO HARDICK LCSW, LMFT
Provider Business Mailing Address
First Line : 1200 WALNUT BOTTOM RD
Second Line : STONER BUILDING, SUITE 311
City : CARLISLE
State : PA
Zip : 17015-7766
Country : US
Telephone Number : 717-243-1511
Fax Number : 717-243-1530
Provider Business Practice Location Address
First Line : 1200 WALNUT BOTTOM RD
Second Line : STONER BUILDING, SUITE 311
City : CARLISLE
State : PA
Zip : 17015-7766
Country : US
Telephone Number : 717-243-1511
Fax Number : 717-243-1530
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 02/25/2008

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