Individual provider Active NPI

Jonathan Hart, LPC

  • Professional Counselor
  • Shelby Township, MI
National Provider Identifier
1821453663
Registry record updated Oct 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401017641 Issued in MI
Practice address
52188 Van Dyke Ave Ste 300
Shelby Township, MI 48316-3575
Phone
(586) 244-8211
NPI assigned
Dec 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2022

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 6401017641 MI Primary

Addresses

Primary practice location

52188 Van Dyke Ave Ste 300
Shelby Township, MI 48316-3575

Mailing address

52188 Van Dyke Ave Ste 300
Shelby TWP, MI 48316-3575
Phone (586) 244-8211

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

State licenses

LicenseStateTypeSpecialty
6401017641MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Psychological Clinic, PLLC CurrentSince Oct 16, 2022 Accepting new patients

Locations

52188 Van Dyke Ave
Ste 300
Shelby Township, MI 48316
Phone (586) 244-8211

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665187200000",
    "number": "1821453663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52188 VAN DYKE AVE STE 300",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483163575",
            "telephone_number": "586-244-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52188 VAN DYKE AVE STE 300",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483163575",
            "telephone_number": "586-244-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "JONATHAN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-21",
        "last_updated": "2022-10-08",
        "certification_date": "2022-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401017641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2022; 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.