Provider Demographics
NPI:1841655644
Name:HARDY, AMAYA NICOLE (LCMHC)
Entity type:Individual
Prefix:MRS
First Name:AMAYA
Middle Name:NICOLE
Last Name:HARDY
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 CONCORD PKWY N STE 350
Mailing Address - Street 2:#1076
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-9687
Mailing Address - Country:US
Mailing Address - Phone:336-541-6242
Mailing Address - Fax:
Practice Address - Street 1:4301 MORRIS PARK DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227
Practice Address - Country:US
Practice Address - Phone:336-541-6242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11986101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional