Provider Demographics
NPI:1508894056
Name:HARDIN, DONALD STEVE (LISW-CP)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:STEVE
Last Name:HARDIN
Suffix:
Gender:M
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 WOODROW ST
Mailing Address - Street 2:# 308
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-1733
Mailing Address - Country:US
Mailing Address - Phone:803-238-1336
Mailing Address - Fax:
Practice Address - Street 1:2212 DEVINE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-2402
Practice Address - Country:US
Practice Address - Phone:803-238-1336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLISW-CP #22151041C0700X
SC22151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSW1154Medicaid
SCQ445610281Medicare PIN