James Robert Hart, BA CAC I

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Lyons, CO

NPI 1679628952 · NPPES record last updated Jun 21, 2012

Key facts

NPI
1679628952
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
6850 (CO)
Practice address
304 Main Street, Unit C
Lyons, CO 80540
Phone
(720) 310-8010
Fax
(303) 823-9355
NPI assigned
Jan 24, 2007
Sex
Male
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
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
13918COMDMental Health Counselor
6850COMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6850 CO Yes
Mental Health Counselor 101YM0800X 13918 CO
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

304 Main Street, Unit C
Lyons, CO 80540

Mailing address

PO Box 499
Lyons, CO 80540-0499
Phone (720) 310-8010

Other names

  • James Robert Ingersoll Other name

Other providers in Lyons, CO

All providers in Lyons, CO · Addiction (Substance Use Disorder) Counselor in Colorado

Sources for this page

Verify at the official NPI Registry.