Provider Demographics
NPI:1578906210
Name:HARDIE-WILLIAMS, KATHY ANN (MED MS NCC LPC LMFT)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:ANN
Last Name:HARDIE-WILLIAMS
Suffix:
Gender:F
Credentials:MED MS NCC LPC LMFT
Other - Prefix:MS
Other - First Name:KATHY
Other - Middle Name:ANN
Other - Last Name:HARDIE-WILLIAMS MED MS NCC LPC LMFT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED MS NCC LPC LMFT
Mailing Address - Street 1:9600 SW OAK ST STE 325
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6588
Mailing Address - Country:US
Mailing Address - Phone:503-206-5578
Mailing Address - Fax:503-935-5884
Practice Address - Street 1:9900 SW GREENBURG RD STE 205
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-5502
Practice Address - Country:US
Practice Address - Phone:503-206-5578
Practice Address - Fax:503-935-5884
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0988106H00000X
ORR2040101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist