Provider Demographics
NPI:1467527622
Name:HARDY, ELISSA (LCSW)
Entity Type:Individual
Prefix:
First Name:ELISSA
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W 14TH AVENUE PKWY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-2749
Mailing Address - Country:US
Mailing Address - Phone:720-865-3443
Mailing Address - Fax:
Practice Address - Street 1:10 W 14TH AVENUE PKWY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2749
Practice Address - Country:US
Practice Address - Phone:720-865-3443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical