Individual provider Active NPI

Gretchen Marie Hart, MA, LLP,LPC, CAADC

  • Professional Counselor
  • Wixom, MI
National Provider Identifier
1164513164
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401003560 Issued in MI
Practice address
29335 Wall St
Wixom, MI 48393-3529
Phone
(248) 770-6499
Fax
(248) 385-2964
NPI assigned
Sep 27, 2006
Last updated
May 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301008426 MI
Professional Counselor 101YP2500X 6401003560 MI Primary

Addresses

Primary practice location

29335 Wall St
Wixom, MI 48393-3529

Mailing address

10708 Kenicott TRL
Brighton, MI 48114-9075
Phone (248) 770-6499

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401003560MIMDProfessional Counselor
6301008426MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1164513164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10708 KENICOTT TRL",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481149075",
            "telephone_number": "248-770-6499",
            "fax_number": "248-385-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29335 WALL ST",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483933529",
            "telephone_number": "248-770-6499",
            "fax_number": "248-385-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "GRETCHEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MA, LLP,LPC, CAADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301008426",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401003560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wixom, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.