Provider Demographics
NPI:1023315942
Name:HARDY, MELINDA MARIE (MSW,BS,LMSW)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:MARIE
Last Name:HARDY
Suffix:
Gender:F
Credentials:MSW,BS,LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMINISTRATION
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:141 E MAIN ST
Practice Address - Street 2:WATERBURY CLINICAL SERVICES 2ND FLR
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-2310
Practice Address - Country:US
Practice Address - Phone:203-756-7287
Practice Address - Fax:203-596-0722
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00514104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT13671435OtherCAQH
CTD339209OtherVALUE OPTIONS-BEACON HEALTH STRATEGIES
CTNOT ELIGIBLEOtherMHN MANAGED HEALTH NETWORK
CT008090421Medicaid
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CT060669107OtherUNITED BEHAVIORAL HEALTH
CTNOT ELIGIBLEOtherMHN-TRICARE NORTH
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CT060669107OtherCIGNA BEHAVIORAL HEALTH
CT060669107OtherUBH-CONNECTICUT WELLMORE/GRP/FACILITY
CT060669107OtherUBH OXFORD HEALTH FREEDOM/LIBERTY WELLMORE GRP/FACILITY
CT060669107OtherUBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
CT008090421Medicaid