Corie Hargrove, CADC-III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

13772 Issued in WI

Practice address

2405 Northwestern Ave # LL15
Racine, WI 53404-2534

Phone

(262) 260-8370

Fax

(262) 260-8538

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Harvest Consulting Company, LLC

  • Community/Behavioral Health Agency
  • Racine, WI
  • NPI 1982951679
  NPD (past) Authorized official

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1720124019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 DERBY AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534033808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 NORTHWESTERN AVE # LL15",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534042534",
            "telephone_number": "262-260-8370",
            "fax_number": "262-260-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGROVE",
        "first_name": "CORIE",
        "name_prefix": "Mr.",
        "credential": "CADC-III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "13772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39173200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Hanson
• Stephanie B Hanson, LCSW
• Harbor Medical & Associates SC
• Jerry M. Hardacre II, M.D.
• David Lawrence Harenke I, DDS
• Paige Harpenau
• Ashli Harris
• Mary Harris
• Rita S Harris, PTA
• Tammy Marie Harris, PTA

• Addiction (Substance Use Disorder) Counselor in Racine, WI
• Providers in Racine, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.