Kelly Eberhart

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

34011337A Issued in IN

Practice address

17195 Cleveland Rd
South Bend, IN 46635-1415

Phone

(574) 277-0274

NPI assigned

Sep 25, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Clinical Social Worker

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Samaritan Family Health and Counseling Center, Inc.

  • Professional Counselor
  • South Bend, IN
  • NPI 1861721136
  NPD

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1225901382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17195 CLEVELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351415",
            "telephone_number": "574-277-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17195 CLEVELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351415",
            "telephone_number": "574-277-0274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERHART",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34011337A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• E.D. Treatment Center LLC
• Elizabeth A Early, CCC/SLP
• Jonathan Andrew Eash, M.D.
• Lauren Elizabeth Eastwood
• Ellen Jean Eaton, OTR
• Gregg M Ebersole, M.D.
• Edison Lakes Oral Surgery, P.C.
• Andrea R Edmister, AUD
• Morgan Nicole Edmonds, AGPCNP-BC
• Mallory Edmondson, MSDH, RDH

• All providers in South Bend, IN
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.