Provider Demographics
NPI:1356742027
Name:HARDIN, ROBERT C SR (CAC-AD)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:C
Last Name:HARDIN
Suffix:SR
Gender:M
Credentials:CAC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12705 PISCATAWAY LANDING DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-6503
Mailing Address - Country:US
Mailing Address - Phone:240-441-2390
Mailing Address - Fax:
Practice Address - Street 1:3000 PENNSYLVANIA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3718
Practice Address - Country:US
Practice Address - Phone:202-581-0490
Practice Address - Fax:202-581-0496
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC0265101YA0400X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)