Provider Demographics
NPI:1558414375
Name:HARDY, WILLIAM N (LCSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:N
Last Name:HARDY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 BIELBY RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-1055
Mailing Address - Country:US
Mailing Address - Phone:812-537-1302
Mailing Address - Fax:
Practice Address - Street 1:283 BIELBY RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1182
Practice Address - Country:US
Practice Address - Phone:812-537-1302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34001497A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000200288OtherBLUE SHIELD
IN172160DMedicare ID - Type UnspecifiedMEDICARE