Individual provider Active NPI

Elizabeth Hardy

  • Clinical Social Worker
  • Shallotte, NC
National Provider Identifier
1144516089
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C007240 Issued in NC
Practice address
3640 Express Dr
Shallotte, NC 28470-6501
Phone
(910) 755-5222
Fax
(910) 755-5255
NPI assigned
Jun 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C007240 NC Primary

Addresses

Primary practice location

3640 Express Dr
Shallotte, NC 28470-6501

Mailing address

4910 Bridger Rd
Apt 18
Shallotte, NC 28470-4520
Phone (914) 309-2626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C007240NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1144516089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 BRIDGER RD",
            "address_2": "APT 18",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704520",
            "telephone_number": "914-309-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 EXPRESS DR",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284706501",
            "telephone_number": "910-755-5222",
            "fax_number": "910-755-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.