MEDICARE: JENNIFER HARDAWAY

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	101YP2500X	Professional Counselor	90116	TX

General Provider Information

NPI Number	:	1417781436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER HARDAWAY

Provider Business Mailing Address
First Line	:	4601 66TH ST STE E
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79414-4875
Country	:	US
Telephone Number	:	806-630-0126
Fax Number	:	806-722-5225

Provider Business Practice Location Address
First Line	:	2100 VALLEY VIEW LN STE 400
Second Line	:
City	:	FARMERS BRANCH
State	:	TX
Zip	:	75234-1271
Country	:	US
Telephone Number	:	469-546-7746
Fax Number	:	806-722-5225

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

Provider Enumeration Date	:	08/30/2024
Last Update Date	:	01/12/2026

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Directions to “ JENNIFER HARDAWAY ” Practice Location

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