Provider Demographics
NPI:1427760172
Name:HARDY, KAMRI N
Entity type:Individual
Prefix:
First Name:KAMRI
Middle Name:N
Last Name:HARDY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:KAMRI
Other - Middle Name:N
Other - Last Name:WOLVERTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2526
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64803-2526
Mailing Address - Country:US
Mailing Address - Phone:417-347-7630
Mailing Address - Fax:
Practice Address - Street 1:530 E 34TH ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3926
Practice Address - Country:US
Practice Address - Phone:417-347-7630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-14
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20250096591041C0700X
MO20220456661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical