Provider Demographics
NPI:1871298406
Name:HARDY, SAMANTHA (MFT)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 N RAVENSWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1710
Mailing Address - Country:US
Mailing Address - Phone:872-213-5344
Mailing Address - Fax:
Practice Address - Street 1:500 DAVIS ST STE 508
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4621
Practice Address - Country:US
Practice Address - Phone:872-213-5344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist