Keah Odom

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

60335 Issued in TX

Practice address

9696 Skillman St Ste 170
Dallas, TX 75243-8253

Phone

(469) 680-3500

NPI assigned

Mar 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1801390166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 ACOSTA LN",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750676143",
            "telephone_number": "254-413-6539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9696 SKILLMAN ST STE 170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752438253",
            "telephone_number": "469-680-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16160 Midway Rd Ste 218",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "TX",
            "postal_code": "750014207",
            "country_code": "US",
            "telephone_number": "469-690-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODOM",
        "first_name": "KEAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "60335",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Rose Odom, LVN, IBCLC
• Brooke Odom, LPC-A
• Charles Odom, M.D.
• Floyd C Odom, MD
• Joshua Alan Odom, LICSW
• Sue Tannehill Odom, PA-C
• Travis Edward Odom
• Dylan P Odonnell, RBT
• Shane Odonnell, DO
• Elizabeth Anne Odstrcil, M.D.

• Clinical Social Worker in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.