Provider Demographics
NPI:1447081591
Name:HARDY, MICHELE DIANE (LMSW)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:DIANE
Last Name:HARDY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 N MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-9154
Mailing Address - Country:US
Mailing Address - Phone:501-786-0662
Mailing Address - Fax:
Practice Address - Street 1:10201 W MARKHAM ST STE 212
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2181
Practice Address - Country:US
Practice Address - Phone:501-500-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPLMSW104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker