Provider Demographics
NPI:1548607161
Name:HARDIMAN, DEANNA (LPC)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:HARDIMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:LATOYA
Other - Last Name:HEMPHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHPP
Mailing Address - Street 1:201 S ROSE ST
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-2451
Mailing Address - Country:US
Mailing Address - Phone:870-917-2171
Mailing Address - Fax:870-917-2161
Practice Address - Street 1:201 S ROSE ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150
Practice Address - Country:US
Practice Address - Phone:870-917-2171
Practice Address - Fax:870-917-2161
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1710371101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional