Basic Information
| Provider Information | |||||||||
| NPI: | 1194703389 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARDIN | ||||||||
| FirstName: | LOTA | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 DONS WAY | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 71913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016205130 | ||||||||
| FaxNumber: | 5016205109 | ||||||||
| Practice Location | |||||||||
| Address1: | 1615 MARTIN LUTHER KING BLVD | ||||||||
| Address2: | |||||||||
| City: | MALVERN | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721042233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5013325236 | ||||||||
| FaxNumber: | 5016205109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/06/2006 | ||||||||
| LastUpdateDate: | 12/19/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | P0512068 | AR | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 1194703389 | 01 | NOVASYS | OTHER | 2274504 | 01 | AR | CIGNA BEHAVIORAH HEALTH | OTHER | 990371 | 01 | AR | USA MANAGED CARE | OTHER | 1194703389 | 01 | TRICARE | OTHER | 830935000 | 01 | AR | MAGELLAN | OTHER | 1194703389 | 01 | VALUE OPTIONS | OTHER | 374544 | 01 | AR | MHN | OTHER | 116399726 | 05 | AR | MEDICAID | 06010017000 | 01 | AR | QUAL-CHOICE | OTHER | 1194703389 | 01 | UNITY MGED MENTAL HEALTH | OTHER | 71-0401764 | 01 | AR | CORPHEALTH | OTHER | 5Y664 | 01 | AR | BLUE CROSS BLUE SHIELD | OTHER |