Active NPI
Jonathan Hart, LPC
- Professional Counselor
- Shelby Township, MI
National Provider Identifier
1821453663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401017641
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 6401017641 | MI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lighthouse Psychological Clinic, PLLC | Current | 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.
-
- Mental Health Counselor
- Shelby TWP, MI
- NPI 1700501087
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.