Kevin L Hackworth, MA, LPC, LLP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401017843 Issued in MI

Practice address

37 E Main St Ste G
Fremont, MI 49412-1295

Phone

(231) 233-1097

NPI assigned

Sep 19, 2016

Last updated

May 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevinhackworth@tdh.allscriptsdirect.net

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.

• Paladins Perspective

  • Professional Counselor
  • Fremont, MI
  • NPI 1922502970
  Medicare reassignment NPD Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1265980395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7322 ROLLING RD",
            "city": "NEWAYGO",
            "state": "MI",
            "postal_code": "493378702",
            "telephone_number": "231-233-1097",
            "fax_number": "269-224-9115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 E MAIN ST STE G",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494121295",
            "telephone_number": "231-233-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKWORTH",
        "first_name": "KEVIN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MA, LPC, LLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-19",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401017843",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016876",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerber Memorial Health Services (Counseling Center of GMHS)
• Anna Girgenti, LPC
• John P Giroux
• Greenlund Enterprises, Inc
• Nicole Lee Greer, LLMSW
• Krisy L Hanna, R.N.
• Robert Michael Hardy, OD
• Dawn Harrison, LMFT
• Michael E Havens, RD, LD, CNSC
• Correen Leeann Hayes, O.D.

• Mental Health Counselor in Fremont, MI
• Providers in Fremont, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.