Provider Demographics
NPI:1053309021
Name:HARDY, NANCY J (LISW)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:J
Last Name:HARDY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MESSIMER DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1842
Mailing Address - Country:US
Mailing Address - Phone:740-522-2230
Mailing Address - Fax:740-522-6230
Practice Address - Street 1:60 MESSIMER DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1842
Practice Address - Country:US
Practice Address - Phone:740-522-2230
Practice Address - Fax:740-522-6230
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLISWI7437104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHASW16433Medicare ID - Type Unspecified
S27804Medicare UPIN