Provider Demographics
NPI:1477955813
Name:HARDESSEN EDWARDS, ERICA JANE (LCSW, LIMHP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:JANE
Last Name:HARDESSEN EDWARDS
Suffix:
Gender:F
Credentials:LCSW, LIMHP
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:JANE
Other - Last Name:HARDESSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LIMHP
Mailing Address - Street 1:3710 CENTRAL AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-8126
Mailing Address - Country:US
Mailing Address - Phone:308-251-2222
Mailing Address - Fax:
Practice Address - Street 1:3710 CENTRAL AVE STE 9
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-8126
Practice Address - Country:US
Practice Address - Phone:308-251-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NE6946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026842900Medicaid
NE10025173200Medicaid
NE10025173100Medicaid
NE10026194400Medicaid