Provider Demographics
NPI:1235503418
Name:HARDY, CINDY (EDD, MAC, LPC)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:EDD, MAC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1057 REDHEAD CT
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-4473
Mailing Address - Country:US
Mailing Address - Phone:678-209-2394
Mailing Address - Fax:706-553-8306
Practice Address - Street 1:120 MLK SR HERITAGE TRL STE 110
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3411
Practice Address - Country:US
Practice Address - Phone:770-990-2453
Practice Address - Fax:706-553-8306
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-25
Last Update Date:2018-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA58595101YA0400X
GA780101YA0400X
GALPC009820101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)