Individual provider Active NPI

Kristin Hardy

  • Professional Counselor
  • Mount Clemens, MI
National Provider Identifier
1205350675
Registry record updated Jul 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401012721 Issued in MI
Practice address
117 Cass Ave Ste 309
Mount Clemens, MI 48043-8805
Phone
(586) 468-0401
NPI assigned
Jul 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401012721 MI Primary

Addresses

Primary practice location

117 Cass Ave Ste 309
Mount Clemens, MI 48043-8805

Mailing address

38900 Harper Ave
Clinton Township, MI 48036-3222
Phone (586) 463-2921

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
6401012721MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Lutheran Church CurrentSince Sep 1, 2024 Accepting new patients
Douglas Shore & Sylvia Voelker PTRS Past Accepting new patients

Locations

38900 Harper Ave
Clinton Township, MI 48036
Phone (586) 463-2921

36405 Harper Ave
Clinton Twp, MI 48035
Phone (586) 468-0401

117 Cass Ave
Ste 309
Mount Clemens, MI 48043
Phone (586) 463-2921

Organizations & group practices 2

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": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1205350675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38900 HARPER AVE",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480363222",
            "telephone_number": "586-463-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 CASS AVE STE 309",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480438805",
            "telephone_number": "586-468-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "KRISTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401012721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; 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.