Individual provider Active NPI

Yasir Ahamed Habeeb Mohamed, MS, LPC

  • Professional Counselor
  • Lebanon, PA
National Provider Identifier
1629449889
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC010554 Issued in PA
Practice address
239 S Butler Rd
Lebanon, PA 17042-8939
Phone
(717) 273-8871
Fax
(717) 270-2452
NPI assigned
Oct 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC010554 PA Primary

Addresses

Primary practice location

239 S Butler Rd
Lebanon, PA 17042-8939

Mailing address

785 5TH Ave Ste 3
Chambersburg, PA 17201-4232
Phone (717) 263-9555

Other practice location 1

283 S Butler Rd
Lebanon, PA 17042-8939
Phone (717) 273-8871

Other practice location 2

283 S Butler Rd
Lebanon, PA 17042-8939
Phone (717) 273-8871

Other identifiers 2

IdentifierTypeStateIssuer
PC010554OtherPASTATE LICENSE - LPC
103812843MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240425000091 PA Practitioner - Mental Health Counselor 6204285877

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

601 Memory Lane
York, PA 17402-2231

601 Memory LN
York, PA 17402-2231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PC010554PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Philhaven Current Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

785 5th Ave
Ste 3
Chambersburg, PA 17201

283 S Butler Rd
Lebanon, PA 17042

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

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": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1629449889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 5TH AVE STE 3",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014232",
            "telephone_number": "717-263-9555",
            "fax_number": "717-709-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 S BUTLER RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170428939",
            "telephone_number": "717-273-8871",
            "fax_number": "717-270-2452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "283 S Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170428939",
            "country_code": "US",
            "telephone_number": "717-273-8871",
            "fax_number": "717-270-2442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "283 S Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170428939",
            "country_code": "US",
            "telephone_number": "717-273-8871",
            "fax_number": "717-270-2452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HABEEB MOHAMED",
        "first_name": "YASIR",
        "middle_name": "AHAMED",
        "name_prefix": "Mr.",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-14",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC010554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE - LPC",
            "identifier": "PC010554",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103812843",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.