Provider Demographics
NPI:1326396987
Name:HARDENBROOK, JOE (M DIV, MFT, LPC)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:HARDENBROOK
Suffix:
Gender:M
Credentials:M DIV, MFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7729 MAVERICK
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141
Mailing Address - Country:US
Mailing Address - Phone:702-994-9742
Mailing Address - Fax:
Practice Address - Street 1:7729 MAVERICK
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141
Practice Address - Country:US
Practice Address - Phone:702-994-9742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNONE101YP1600X
ORNONE106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist