Provider Demographics
NPI:1477969293
Name:HARDIN, TISHA NACOLE (LISW-S, LICDC)
Entity type:Individual
Prefix:MS
First Name:TISHA
Middle Name:NACOLE
Last Name:HARDIN
Suffix:
Gender:F
Credentials:LISW-S, LICDC
Other - Prefix:
Other - First Name:TISHA
Other - Middle Name:NACOLE
Other - Last Name:HARDIN-SPRADLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:720 COOL SPRINGS BLVD SUITE 500
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067
Mailing Address - Country:US
Mailing Address - Phone:855-950-5035
Mailing Address - Fax:
Practice Address - Street 1:690 COOPER RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081
Practice Address - Country:US
Practice Address - Phone:855-950-5035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHICDC.111052101YA0400X
OHS.1440382104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)