Provider Demographics
NPI:1912470576
Name:HARDESTY, SABINA JULIA (PLMHP, PCMSW)
Entity Type:Individual
Prefix:
First Name:SABINA
Middle Name:JULIA
Last Name:HARDESTY
Suffix:
Gender:F
Credentials:PLMHP, PCMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8233 MACKENZIE RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2068
Mailing Address - Country:US
Mailing Address - Phone:402-570-0401
Mailing Address - Fax:
Practice Address - Street 1:4701 VAN DORN ST STE B
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2511
Practice Address - Country:US
Practice Address - Phone:402-570-0401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11731101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health