Provider Demographics
NPI:1649087396
Name:HARDY, TIKO S (LAC, LCSW, PSYD)
Entity type:Individual
Prefix:DR
First Name:TIKO
Middle Name:S
Last Name:HARDY
Suffix:
Gender:F
Credentials:LAC, LCSW, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1257 LAKE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3553
Mailing Address - Country:US
Mailing Address - Phone:719-424-4653
Mailing Address - Fax:719-579-9094
Practice Address - Street 1:1257 LAKE PLAZA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3553
Practice Address - Country:US
Practice Address - Phone:719-424-4653
Practice Address - Fax:719-579-9094
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001423101YA0400X
CO101YM0800X, 101YP2500X, 104100000X
CO00099203991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker