Michael B Hazeltine, M.A., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

79720 Issued in TX

Practice address

218 N College Ave
Tyler, TX 75702-5715

Phone

(903) 593-9141

NPI assigned

Jul 16, 2018

Last updated

Dec 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Console Counseling LLCGroup PAC ID 8224535190, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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

• Console Counseling LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1699563213
  Medicare reassignment Care Compare group NPD Authorized official
• Second Story Counseling II LLC

  • Counselor
  • Hudsonville, MI
  • NPI 1013460716
  Medicare reassignment NPD
• Mosaic Counseling Centers of East Texas

  • Professional Counselor
  • Tyler, TX
  • NPI 1649554676
  NPD (past)

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1215413091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 N COLLEGE AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757025715",
            "telephone_number": "903-593-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 N COLLEGE AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757025715",
            "telephone_number": "903-593-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELTINE",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "M.A., LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Hays, RN
• Markie Lynn Hays
• Tanner Lee Hays, DC
• Lucille Hayter
• Puja Hazari, APRN, FNP-C
• Denise N Hazen, LPC
• Dustin Head
• Kay Head, RD LD
• Brittany Lauren Healey, PA-C
• Healing Hearts Family Counseling LLC

• Professional Counselor in Tyler, TX
• Providers in Tyler, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.