MR. SHANE TYLER HART LCPC
NPI 1811573389
Counselor - Professional in Baltimore, MD

Active since March 23, 2021Opted out of Medicare · through May 3, 2028
6501 N CHARLES ST, BALTIMORE, MD 21204(410) 938-3000 Get Directions Write a Review

NPPES record last updated: March 23, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Shane Tyler Hart Lcpc NPPES

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

MR. SHANE TYLER HART LCPC (NPI 1811573389) is an individual professional provider in Baltimore, Maryland, licensed in Maryland (LC8801) and active in the NPI registry since March 2021. He has opted out of Medicare through May 3, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1811573389
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. SHANE TYLER HARTCredential: LCPC
Location Address6501 N CHARLES STBaltimore, MD 21204-6819
Mailing Address6501 N Charles StBaltimore, MD 21204-6819 · (410) 938-3000
Sole ProprietorNo
Enumeration DateMarch 23, 2021
NPPES CertifiedMarch 23, 2021
NPI 1811573389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in MD · LC8801
6501 N CHARLES ST, Baltimore, MD 21204

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Mr. Shane Tyler Hart Lcpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 3, 2024 through May 3, 2028.

Opt-Out Effective DateMay 3, 2024
Opt-Out In Effect ThroughMay 3, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

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

Speech-Language Pathologist
6501 N CHARLES ST
TOWSON, MD 21204
Nurse Practitioner (Psychiatric/Mental Health)
6501 N CHARLES ST
TOWSON, MD 21204
Nurse Practitioner (Psychiatric/Mental Health)
6501 N CHARLES ST
BALTIMORE, MD 21204
Psychiatry & Neurology (Psychiatry)
6501 N CHARLES ST
BALTIMORE, MD 21204
Psychologist (Clinical)
6501 N CHARLES ST
BALTIMORE, MD 21204
Psychologist (Clinical)
6501 N CHARLES ST
TOWSON, MD 21204
Social Worker (Clinical)
6501 N CHARLES ST
BALTIMORE, MD 21204
Psychiatry & Neurology (Psychiatry)
6501 N CHARLES ST
BALTIMORE, MD 21204

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 Shane Hart's NPI number?

The NPI number for Shane Hart is 1811573389. It was assigned to this individual provider in the NPPES registry on March 23, 2021.

Where is Shane Hart located?

Shane Hart practices at 6501 N Charles St, Baltimore, MD 21204. The listed phone number is (410) 938-3000.

What is Shane Hart's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Shane Hart enrolled in Medicare?

No. Shane Hart has opted out of Medicare through May 3, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Shane Hart was last updated on March 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.