Provider Demographics
NPI:1184195570
Name:HARDYMON, REBECCA KAY (CDCA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:KAY
Last Name:HARDYMON
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:KAY
Other - Last Name:ROTHWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDCA
Mailing Address - Street 1:4600 MONTGOMERY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:421 HOME ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121-1407
Practice Address - Country:US
Practice Address - Phone:833-510-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.171250101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)