Organization Active NPI

Hazel'S Heart LLC

  • Mental Health Counselor
  • South Bend, IN
National Provider Identifier
1114801602
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
HAZEL'S HEART LLC
Practice address
719 N Notre Dame Ave
South Bend, IN 46617-2052
Phone
(831) 521-4501
NPI assigned
Aug 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Authorized official

Name
Valerie Golden
Title
Owner
Phone
(831) 521-4501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

719 N Notre Dame Ave
South Bend, IN 46617-2052

Mailing address

330 W Colfax Ave Apt 119
South Bend, IN 46601-1557
Phone (831) 521-4501

National Provider Directory

National Provider Directory

Locations

719 N Notre Dame Ave
South Bend, IN 46617
Phone (831) 521-4501

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1754352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1114801602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W COLFAX AVE APT 119",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011557",
            "telephone_number": "831-521-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 N NOTRE DAME AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172052",
            "telephone_number": "831-521-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZEL'S HEART LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "GOLDEN",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "831-521-4501"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.