Provider Demographics
NPI:1205480944
Name:HARDER, NICHOLAS CUSHMAN
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:CUSHMAN
Last Name:HARDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 VILLAGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01096-9706
Mailing Address - Country:US
Mailing Address - Phone:917-805-1498
Mailing Address - Fax:
Practice Address - Street 1:20 VILLAGE HILL RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:MA
Practice Address - Zip Code:01096-9706
Practice Address - Country:US
Practice Address - Phone:917-805-1498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101Y00000XBehavioral Health & Social Service ProvidersCounselor