Individual provider Active NPI

Hope Koram, LMHC

  • Mental Health Counselor
  • Medford, MA
National Provider Identifier
1033768718
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMHC5000921 Issued in MA
Practice address
15 Carberry St
Medford, MA 02155-1804
Phone
(617) 756-6267
NPI assigned
Sep 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMHC5000921 MA Primary

Addresses

Primary practice location

15 Carberry St
Medford, MA 02155-1804

Mailing address

15 Carberry St
Medford, MA 02155-1804
Phone (617) 756-6267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124002500 MA Practitioner - Mental Health Counselor 1456704691 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMHC5000921MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
SB Transitional Sub, LLC CurrentSince Jan 1, 2024 Accepting new patients
South Bay Mental Health Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

103 Commercial St
Ste 2
Brockton, MA 02302

1115 W Chestnut St
Brockton, MA 02301
Phone (508) 559-0473

37 Water St
Ste 1
Wakefield, MA 01880
Phone (781) 223-8042

Organizations & group practices 2

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": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1033768718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CARBERRY ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551804",
            "telephone_number": "617-756-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CARBERRY ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551804",
            "telephone_number": "617-756-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORAM",
        "first_name": "HOPE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LMHC5000921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.