MEDICARE: MICAELA HARDYMAN PSY.D

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	103T00000X	Psychologist	0006941	CO

General Provider Information

NPI Number	:	1871322461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICAELA HARDYMAN PSY.D

Provider Business Mailing Address
First Line	:	3445 WADSWORTH BLVD APT 1
Second Line	:
City	:	WHEAT RIDGE
State	:	CO
Zip	:	80033-4630
Country	:	US
Telephone Number	:	864-979-3523
Fax Number	:

Provider Business Practice Location Address
First Line	:	12631 E 17TH AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-2527
Country	:	US
Telephone Number	:	303-887-6343
Fax Number	:

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

Provider Enumeration Date	:	07/31/2024
Last Update Date	:	01/13/2026

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