Organization Active NPI

Khalil Psychological Services

  • Clinical Psychologist
  • Fort Wayne, IN
National Provider Identifier
1639064082
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
KHALIL PSYCHOLOGICAL SERVICES
Practice address
124 W Superior St Unit 659
Fort Wayne, IN 46802-1259
Phone
(260) 217-4384
NPI assigned
Jun 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Authorized official

Name
Dr. Amani Khalil, PHD, HSPPNPI 1144045568
Title
Owner
Phone
(260) 217-4384

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

124 W Superior St Unit 659
Fort Wayne, IN 46802-1259

Mailing address

124 W Superior St Unit 659
Fort Wayne, IN 46802-1259

National Provider Directory

National Provider Directory

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": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1639064082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 W SUPERIOR ST UNIT 659",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 W SUPERIOR ST UNIT 659",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021259",
            "telephone_number": "260-217-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHALIL PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "KHALIL",
        "authorized_official_first_name": "AMANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-217-4384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, HSPP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.