Provider Demographics
NPI:1134399215
Name:HARDIN, DANIEL ROY (LPC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ROY
Last Name:HARDIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3573 RUGBY DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-4362
Mailing Address - Country:US
Mailing Address - Phone:208-407-9227
Mailing Address - Fax:
Practice Address - Street 1:3573 RUGBY DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-4362
Practice Address - Country:US
Practice Address - Phone:208-407-9227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID3839101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health