Provider Demographics
NPI:1487154639
Name:HARDY, NICOLE RIIS (LCSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:RIIS
Last Name:HARDY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 PATTON AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2623
Mailing Address - Country:US
Mailing Address - Phone:828-395-0811
Mailing Address - Fax:877-919-0850
Practice Address - Street 1:1340 PATTON AVE STE D
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2623
Practice Address - Country:US
Practice Address - Phone:828-395-0811
Practice Address - Fax:877-919-0850
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC012421104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty