Provider Demographics
NPI:1033763768
Name:HARDIN, DELMAR DONTE (LCDC III)
Entity Type:Individual
Prefix:
First Name:DELMAR
Middle Name:DONTE
Last Name:HARDIN
Suffix:
Gender:M
Credentials:LCDC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1765 E WATERFORD CT APT 1013
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-8383
Mailing Address - Country:US
Mailing Address - Phone:330-814-6681
Mailing Address - Fax:
Practice Address - Street 1:1765 E WATERFORD CT APT 1013
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-8383
Practice Address - Country:US
Practice Address - Phone:330-814-6681
Practice Address - Fax:330-996-2233
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA167935101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)