1578906210 NPI number — MS. KATHY ANN HARDIE-WILLIAMS M.ED MS NCC LPC LMFT

Table of content: MS. KATHY ANN HARDIE-WILLIAMS M.ED MS NCC LPC LMFT (NPI 1578906210)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578906210 NPI number — MS. KATHY ANN HARDIE-WILLIAMS M.ED MS NCC LPC LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARDIE-WILLIAMS
Provider First Name:
KATHY
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.ED MS NCC LPC LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARDIE-WILLIAMS MED MS NCC LPC LMFT
Provider Other First Name:
KATHY
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MED MS NCC LPC LMFT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1578906210
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9600 SW OAK ST STE 325
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TIGARD
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97223-6588
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-206-5578
Provider Business Mailing Address Fax Number:
503-935-5884

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9900 SW GREENBURG RD STE 205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TIGARD
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97223-5502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-206-5578
Provider Business Practice Location Address Fax Number:
503-935-5884
Provider Enumeration Date:
04/11/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  T0988 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: R2040 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com