MEDICARE: ERIN BARDONER

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

General Provider Information

NPI Number	:	1447997721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN BARDONER

Provider Business Mailing Address
First Line	:	1923 CHEROKEE DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39211-6509
Country	:	US
Telephone Number	:	423-637-0647
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 PROFESSIONAL PKWY
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-4113
Country	:	US
Telephone Number	:	601-780-7400
Fax Number	:

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

Provider Enumeration Date	:	05/17/2022
Last Update Date	:	02/05/2026

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Directions to “ ERIN BARDONER ” Practice Location

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