Individual provider Active NPI

Keilah Hamood, LMHC

  • Mental Health Counselor
  • Elkhart, IN
National Provider Identifier
1821593989
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
240 Waterfall Dr
Elkhart, IN 46516-3668
Phone
(574) 404-8800
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X IN Primary

Addresses

Primary practice location

240 Waterfall Dr
Elkhart, IN 46516-3668

Mailing address

240 Waterfall Dr
Elkhart, IN 46516-3668
Phone (574) 404-8800

Other practice location 1

1102 Fellows St
South Bend, IN 46601-3514
Phone (574) 233-9491 ext. 348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 3, 2025 through Jan 3, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Counseling Services, LLC Mental Health CurrentSince Feb 13, 2022 Accepting new patients

Locations

240 Waterfall Dr
Elkhart, IN 46516
Phone (574) 222-6514

Organizations & group practices 1

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1821593989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 WATERFALL DR",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465163668",
            "telephone_number": "574-404-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WATERFALL DR",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465163668",
            "telephone_number": "574-404-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1102 Fellows St",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466013514",
            "country_code": "US",
            "telephone_number": "574-233-9491 x348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMOOD",
        "first_name": "KEILAH",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.