Provider Demographics
NPI:1568441731
Name:HARDWICK, CYNTHIA J (PHD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:HARDWICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PARKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-4908
Mailing Address - Country:US
Mailing Address - Phone:910-485-1819
Mailing Address - Fax:910-485-1870
Practice Address - Street 1:100 PARKVIEW AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-4908
Practice Address - Country:US
Practice Address - Phone:910-485-1819
Practice Address - Fax:910-485-1870
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2100103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6177283OtherUNITED BEHAVIORAL HEALTH
NC175225OtherCOMPSYCH
NC6107283OtherMAILHANDLER'S BENEFIT PLA
NCA3057OtherMEDCOST
NC122416OtherVALUE OPTIONS
NC0339BOtherBCBS OF NC
NC2816384AMedicare ID - Type Unspecified