Hardy, Derick Jerome

Hardy, Derick Jerome is an sole proprietor health care provider with primary practice located at 1202 Kirkman St Ste A , Lake Charles LA 70601-5391. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Psychoanalyst. Other Service Providers / Case Manager/Care Coordinator is his primary health care specialty. Hardy, Derick Jerome can be contacted via phone (337) 419-3586.

Contact Information

Primary practice address
1202 Kirkman St Ste A Lake Charles LA 70601-5391
Phone: (337) 419-3586
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Psychoanalyst 102L00000X

Profile Details

NPI number 1225496888
LBN Legal business name Hardy, Derick Jerome
Credentials MASTERS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 10th, 2016
Last updated May 11th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225496888 NPPES
Louisiana MEDICAID 1889253

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