Provider Demographics
NPI:1225180839
Name:HARDY, DOREEN FRANCES (LICSW)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:FRANCES
Last Name:HARDY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WENTWORTH DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501
Mailing Address - Country:US
Mailing Address - Phone:508-832-5880
Mailing Address - Fax:508-421-9382
Practice Address - Street 1:4 CAROLINE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604
Practice Address - Country:US
Practice Address - Phone:508-757-0376
Practice Address - Fax:508-421-9382
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10201941041C0700X
MA111931163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health