Provider Demographics
NPI:1205545472
Name:HARDLEY, TERESA ANNE (LCSW)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:ANNE
Last Name:HARDLEY
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 1:222 HAVERHILL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-3206
Mailing Address - Country:US
Mailing Address - Phone:708-214-2392
Mailing Address - Fax:
Practice Address - Street 1:12343 HYMEADOW DR STE 3E
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1858
Practice Address - Country:US
Practice Address - Phone:512-861-4154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX689261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical