Provider Demographics
NPI:1669038618
Name:HARDIN, JANNESSA JEAN (LCSW)
Entity Type:Individual
Prefix:
First Name:JANNESSA
Middle Name:JEAN
Last Name:HARDIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4721 WOODFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3803
Mailing Address - Country:US
Mailing Address - Phone:816-341-6475
Mailing Address - Fax:
Practice Address - Street 1:4721 WOODFIELD DR
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3803
Practice Address - Country:US
Practice Address - Phone:816-341-6475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190255571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical