Individual provider Active NPI

Therese Ann Hardison, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1205512555
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2023024663 Issued in MO
Practice address
7750 Clayton Rd Ste 303
Saint Louis, MO 63117-1341
Phone
(314) 649-3008
NPI assigned
Jun 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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 2023024663 MO Primary

Addresses

Primary practice location

7750 Clayton Rd Ste 303
Saint Louis, MO 63117-1341

Mailing address

5109 Lakewood Ave
Saint Louis, MO 63123-3719
Phone (708) 921-1151

Other names 1

  • Tess Hardison Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thardison@integrativemindinstitute.com Direct

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
2023024663MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Mind Institute, LLC CurrentSince Jun 25, 2023 Accepting new patients

Locations

7750 Clayton Rd
Ste 303
Saint Louis, MO 63117
Phone (314) 489-4810

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1205512555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 LAKEWOOD AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631233719",
            "telephone_number": "708-921-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7750 CLAYTON RD STE 303",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171341",
            "telephone_number": "314-649-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDISON",
        "first_name": "THERESE",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2023024663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thardison@integrativemindinstitute.com",
            "affiliation": "N",
            "endpointDescription": "secure, work only email where protected health information can be received",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7750 Clayton Rd Ste 303",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631171341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TESS",
            "last_name": "HARDISON",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.