Individual provider Active NPI

Ian Andrew Belmont -Hardwick, LPC

  • Professional Counselor
  • Roseburg, OR
National Provider Identifier
1407136492
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
272 NW Medical Loop
Suite E
Roseburg, OR 97471
Phone
(541) 900-4285
Fax
(888) 810-2993
NPI assigned
Aug 22, 2011
Last updated
Feb 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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 NU Primary

Addresses

Primary practice location

272 NW Medical Loop
Suite E
Roseburg, OR 97471

Mailing address

272 NW Medical Loop
Suite E
Roseburg, OR 97471
Phone (541) 900-4285

Other practice location 1

1126 Gateway Loop Ste 140
Springfield, OR 97477-7722
Phone (541) 654-8107

Other identifiers 1

IdentifierTypeStateIssuer
019047MedicaidOR

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roseburg Therapy LLC Current Accepting new patients

Locations

272 NW Medical Loop
Ste E
Roseburg, OR 97471
Phone (541) 677-6141

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1407136492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 NW MEDICAL LOOP",
            "address_2": "SUITE E",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "97471",
            "telephone_number": "541-900-4285",
            "fax_number": "888-810-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 NW MEDICAL LOOP",
            "address_2": "SUITE E",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "97471",
            "telephone_number": "541-900-4285",
            "fax_number": "888-810-2993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1126 Gateway Loop Ste 140",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974777722",
            "country_code": "US",
            "telephone_number": "541-654-8107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELMONT -HARDWICK",
        "first_name": "IAN",
        "middle_name": "ANDREW",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-22",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019047",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.