Provider Demographics
NPI:1043752090
Name:HARDY, AMANDA (PHD, MA, LMHC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:PHD, MA, LMHC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:HARDY
Other - Last Name:HILLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, MA, LMHC
Mailing Address - Street 1:PO BOX 41474
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50311-0508
Mailing Address - Country:US
Mailing Address - Phone:515-218-9182
Mailing Address - Fax:
Practice Address - Street 1:1107 46TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50311-3309
Practice Address - Country:US
Practice Address - Phone:515-218-9182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2021-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00503300101YM0800X
IA085422101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA814341897Medicaid