DR. BRUCE PATRICK HACKWORTH PHD
NPI 1063448918
Psychologist in Saint Joseph, MI

Active since June 23, 2006PECOS Enrolled
811 SHIP ST, SUITE 4B, SAINT JOSEPH, MI 49085(269) 985-3618(269) 609-6009 Get Directions Write a Review

NPPES record last updated: January 1, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Bruce Patrick Hackworth Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BRUCE PATRICK HACKWORTH PHD (NPI 1063448918) is an individual psychologist in Saint Joseph, Michigan, licensed in Michigan (6801018724) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1996).

NPPES Registry Identity

NPI1063448918
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. BRUCE PATRICK HACKWORTHCredential: PHD
Location Address811 SHIP ST, SUITE 4BSaint Joseph, MI 49085-1171
Mailing Address811 Ship St, Suite 4bSaint Joseph, MI 49085-1171 · (269) 985-3618 · Fax (269) 609-6009
Fax(269) 609-6009
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateJune 23, 2006
Last NPPES UpdateJanuary 1, 2016
✔ NPI 1063448918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MI · 6801018724
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
811 SHIP ST, Saint Joseph, MI 49085

Other Identifiers 3

Other1699155226MI · Lighthouse Behavioral Health Pllc - Group Npi
Medicare PINON26020008MI
Medicaid1716175MI

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Bruce Patrick Hackworth Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2062456031
PECOS Enrollment IDI20050610000813
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Bruce Hackworth reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Counseling
811 SHIP ST, SUITE 4B
Saint Joseph, MI 49085
  • Reassigned Medicare billing, Michigan enrollment
  • 2 clinicians in this Medicare group
Rural Health
6701 PAW PAW AVE
Coloma, MI 49038
  • Reassigned Medicare billing, Michigan enrollment
  • 107 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Counseling)
811 SHIP ST, SUITE 4B
SAINT JOSEPH, MI 49085

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bruce Hackworth's NPI number?

The NPI number for Bruce Hackworth is 1063448918. It was assigned to this individual provider in the NPPES registry on June 23, 2006.

Where is Bruce Hackworth located?

Bruce Hackworth practices at 811 Ship St Suite 4B, Saint Joseph, MI 49085. The listed phone number is (269) 985-3618.

What is Bruce Hackworth's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Bruce Hackworth enrolled in Medicare?

Yes. Bruce Hackworth is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Bruce Hackworth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bruce Hackworth reassigns Medicare benefits to 2 organizations: Lighthouse Behavioral Health, PLLC (Saint Joseph, MI) and Lakeland Community Hospital Watervliet (Coloma, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bruce Hackworth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Bruce Hackworth accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Bruce Hackworth as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bruce Hackworth was last updated on January 1, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.