Adam Richard Shanty, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401222574 Issued in MI

Practice address

41 Washington Ave Ste 308
Grand Haven, MI 49417-1587

Phone

(616) 414-4962

Fax

(616) 344-2131

NPI assigned

Mar 6, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• First Light Counseling LLC

  • Professional Counselor
  • Grand Haven, MI
  • NPI 1861120537
  NPD Authorized official

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1942702816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 SLAYTON AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172039",
            "telephone_number": "616-402-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 WASHINGTON AVE STE 308",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171587",
            "telephone_number": "616-414-4962",
            "fax_number": "616-344-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANTY",
        "first_name": "ADAM",
        "middle_name": "RICHARD",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-06",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401222574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stefanie Shelton
• Ashley Shoemaker, PT

• Counselor in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.