Individual provider Active NPI

Noel Jason Hartough, LMHC

  • Mental Health Counselor
  • Port St Joe, FL
National Provider Identifier
1003695099
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH22574 Issued in FL
Practice address
3050 W Highway 98 Unit C53
Port St Joe, FL 32456-4724
Phone
(615) 498-6435
NPI assigned
Sep 27, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH22574 FL Primary

Addresses

Primary practice location

3050 W Highway 98 Unit C53
Port St Joe, FL 32456-4724

Mailing address

3050 W Highway 98 Unit C53
Port St Joe, FL 32456-4724
Phone (615) 498-6435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241212004166 FL Practitioner - Mental Health Counselor 8921534934 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH22574FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Nov 13, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Networks

  • AL HMO
  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • FL HMO
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • FL HMO D-SNP
  • AL HMO D-SNP
  • FL HMO C-SNP

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": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1003695099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 W HIGHWAY 98 UNIT C53",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324564724",
            "telephone_number": "615-498-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 W HIGHWAY 98 UNIT C53",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324564724",
            "telephone_number": "615-498-6435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTOUGH",
        "first_name": "NOEL",
        "middle_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH22574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Joe, FL

Sources for this page

Verify at the official NPI Registry.