Provider Demographics
NPI:1033537972
Name:HARDY, KELLY D (LPC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:D
Last Name:HARDY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 LAKE ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-5150
Mailing Address - Country:US
Mailing Address - Phone:504-256-7190
Mailing Address - Fax:
Practice Address - Street 1:3905 LAKE ARROWHEAD DR
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5150
Practice Address - Country:US
Practice Address - Phone:504-256-7190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA103357972Medicaid