MEDICARE: KARLEE HARDISON

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	28635	NC
2	101YM0800X	Mental Health Counselor	A18415	NC

General Provider Information

NPI Number	:	1306534516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLEE HARDISON

Provider Business Mailing Address
First Line	:	2756 W ARLINGTON BLVD APT 304
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-4075
Country	:	US
Telephone Number	:	252-414-4079
Fax Number	:

Provider Business Practice Location Address
First Line	:	2577 W ARLINGTON BLVD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-2783
Country	:	US
Telephone Number	:	252-414-4079
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2023
Last Update Date	:	04/26/2023

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Directions to “ KARLEE HARDISON ” Practice Location

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