Provider Demographics
NPI:1922587229
Name:HARDY, MELISSA AMMAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:AMMAN
Last Name:HARDY
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 1:527 ESPLANADE ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3121
Mailing Address - Country:US
Mailing Address - Phone:337-409-9227
Mailing Address - Fax:
Practice Address - Street 1:221 RUE DE JEAN STE 210
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3283
Practice Address - Country:US
Practice Address - Phone:337-409-9227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical