Provider Demographics
NPI:1669778379
Name:HARDEE, ROBERT ALVIN (LCPC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALVIN
Last Name:HARDEE
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11360 S GREENBRIER DR
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-7768
Mailing Address - Country:US
Mailing Address - Phone:702-533-5613
Mailing Address - Fax:702-538-8452
Practice Address - Street 1:84 ELKS PEAK AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-5200
Practice Address - Country:US
Practice Address - Phone:702-533-5613
Practice Address - Fax:702-538-8452
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-28
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-7334101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health