NPIMap

Individual provider Active NPI

Adam Charles McHenry, LLMSW

  • Counselor
  • Port Huron, MI
National Provider Identifier
1003193996
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6801093703 Issued in MI
Practice address
1001 Military St
Port Huron, MI 48060-5416
Phone
(810) 985-5168
Fax
(810) 248-1568
NPI assigned
Nov 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6801093703 MI Primary

Addresses

Primary practice location

1001 Military St
Port Huron, MI 48060-5416

Mailing address

1001 Military St
Port Huron, MI 48060-5416
Phone (810) 985-5168

Other identifiers 1

IdentifierTypeStateIssuer
382230613OtherMIFIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801093703MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Counselor Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1003193996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MILITARY ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480605416",
            "telephone_number": "810-985-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MILITARY ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480605416",
            "telephone_number": "810-985-5168",
            "fax_number": "810-248-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCHENRY",
        "first_name": "ADAM",
        "middle_name": "CHARLES",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-07",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6801093703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIN",
            "identifier": "382230613",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.