Individual provider Active NPI

Jessica Lynn Hardy, APSW

  • Social Worker
  • Burlington, WI
National Provider Identifier
1366059800
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
197 W Chestnut St
Burlington, WI 53105-1200
Phone
(262) 763-9191
NPI assigned
Sep 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Social Worker 104100000X Primary

Addresses

Primary practice location

197 W Chestnut St
Burlington, WI 53105-1200

Mailing address

197 W Chestnut St
Burlington, WI 53105-1200
Phone (262) 763-9191

Other identifiers 1

IdentifierTypeStateIssuer
1366059800OtherNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jhardy@clinicpsych.com

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Behavioral Clinics, SC PastSince Oct 1, 2020 Accepting new patients
Odyssey Healthcare Operating B, LP Past Accepting new patients
Clinical Psychology Associates, LLC PastSince Nov 24, 2020 Accepting new patients
Credence Therapy Associates Inc PastSince Oct 1, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jhardy@clinicpsych.com

Organizations & group practices 4

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": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1366059800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 W CHESTNUT ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051200",
            "telephone_number": "262-763-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 W CHESTNUT ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051200",
            "telephone_number": "262-763-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-29",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1366059800",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jhardy@clinicpsych.com",
            "affiliation": "N",
            "address_1": "197 W Chestnut St",
            "city": "Burlington",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531051200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.