Provider Demographics
NPI:1871117309
Name:HARDY, CHRISTIAN (LIMHP, CPC)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:LIMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 N 115TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4419
Mailing Address - Country:US
Mailing Address - Phone:402-850-3962
Mailing Address - Fax:531-466-7401
Practice Address - Street 1:1055 N 115TH ST STE 105
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4419
Practice Address - Country:US
Practice Address - Phone:402-850-3962
Practice Address - Fax:531-466-7401
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-01
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10027680600Medicaid