Deana Ann Hartshorn, MA, LPC

Key facts

NPI

1609299155

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

License

94948 (TX)

Practice address

1317 N Central Ave
Flagler Beach, FL 32136-3144

Phone

(386) 585-5590

NPI assigned

Feb 3, 2014

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Arts

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 18, 2024.

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1609299155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1482 BRIMBLE DR",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805167254",
            "telephone_number": "303-775-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 N CENTRAL AVE",
            "city": "FLAGLER BEACH",
            "state": "FL",
            "postal_code": "321363144",
            "telephone_number": "386-585-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTSHORN",
        "first_name": "DEANA",
        "middle_name": "ANN",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-03",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0016071",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "94948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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