Individual provider Active NPI

Lynn D Hardy, MA, LP

  • Counseling Psychologist
  • Elk River, MN
National Provider Identifier
1639162407
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
3938 Issued in NU
Practice address
11070 183Rd Cir NW
Elk River, MN 55330-2842
Phone
(763) 633-5111
Fax
(763) 633-5112
NPI assigned
Aug 26, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 3938 NU Primary

Addresses

Primary practice location

11070 183Rd Cir NW
Elk River, MN 55330-2842

Mailing address

11070 183Rd Cir NW
Elk River, MN 55330-2842
Phone (763) 633-5111

Other identifiers 1

IdentifierTypeStateIssuer
640721800MedicaidMN

Other names 1

  • Lynn D Whiting Hardy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402003762 MN Practitioner - Mental Health Counselor 9931564804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3938MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hardy & Stephens Counseling Associates PLLC CurrentSince Jan 6, 2006 Accepting new patients

Locations

11070 183rd Cir NW
Elk River, MN 55330
Phone (763) 633-5111

11070 183rd Cir NW
Ste C
Elk River, MN 55330
Phone (763) 257-5301

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639162407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11070 183RD CIR NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302842",
            "telephone_number": "763-633-5111",
            "fax_number": "763-633-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11070 183RD CIR NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302842",
            "telephone_number": "763-633-5111",
            "fax_number": "763-633-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "LYNN",
        "middle_name": "D",
        "credential": "MA, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": "3938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "640721800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "WHITING HARDY",
            "middle_name": "D",
            "credential": "MA LP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elk River, MN

Sources for this page

Verify at the official NPI Registry.