Basic Information
| Provider Information | |||||||||
| NPI: | 1033148572 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARDMAN | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD, RP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12454 E ALASKA AVE | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800122354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6232251613 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1693 QUENTIN ST | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800452518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7208483000 | ||||||||
| FaxNumber: | 7208483015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 03/16/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | NLC0104740 | CO | N | Behavioral Health & Social Service Providers | Counselor | 101YA0400X | NLC0104740 | CO | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | NLC0104740 | CO | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YA0400X | ACD.0000718 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.