Provider Demographics
NPI:1407451552
Name:CLARDY, KIERSTEN
Entity type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:
Last Name:CLARDY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1357 HILDRETH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-1604
Mailing Address - Country:US
Mailing Address - Phone:404-452-3927
Mailing Address - Fax:
Practice Address - Street 1:1357 HILDRETH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1604
Practice Address - Country:US
Practice Address - Phone:404-452-3927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician