Provider Demographics
NPI:1417672577
Name:AMANDA HARDY, PHD, LLC
Entity Type:Organization
Organization Name:AMANDA HARDY, PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, PMH-C
Authorized Official - Phone:515-218-9182
Mailing Address - Street 1:1107 46TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50311-3309
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:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMANDA HARDY, PHD, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty