Individual
DESERIE M FILLMORE HARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCP, CDP
Contact information
Practice address
135 W MAIN ST, CHEHALIS, WA 98532-4817
(360) 748-6696
Mailing address
519 S IRON ST, CENTRALIA, WA 98531-3923
(253) 882-7623
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60185006
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00003653
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP00003653
CHEMICAL DEPENDENCY PROFESSIONAL
WA
Enumeration date
03/28/2007
Last updated
10/16/2025
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