Individual provider Active NPI

Khaled Awwad, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Waterford, MI
National Provider Identifier
1093689192
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704330112 Issued in MI
Practice address
5770 Highland Rd Ste a
Waterford, MI 48327-1877
Phone
(248) 775-7767
NPI assigned
Oct 1, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704330112 MI Primary

Addresses

Primary practice location

5770 Highland Rd Ste a
Waterford, MI 48327-1877

Mailing address

5770 Highland Rd Ste a
Waterford, MI 48327-1877
Phone (248) 775-7767

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251029002725 MI Practitioner - Nurse Practitioner 0143719245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

52129 Monaco Dr
Macomb, MI 48042-6023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704330112MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Mental Health PLLC Psychiatric/Mental Health CurrentSince Oct 9, 2025 Accepting new patients
Genuine Solutions Counseling Center PastSince Oct 9, 2025 Accepting new patients

Locations

5770 Highland Rd
Ste A
Waterford, MI 48327
Phone (248) 618-3568

Interoperability endpoints

  • Direct secure messaging: khaled.awwad.1@30302.direct.athenahealth.com

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": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1093689192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 HIGHLAND RD STE A",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271877",
            "telephone_number": "248-775-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 HIGHLAND RD STE A",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271877",
            "telephone_number": "248-775-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWWAD",
        "first_name": "KHALED",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-01",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704330112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.