Individual provider Active NPI

Momi Yamanaka, PH.D.

  • Psychologist
  • Carmel, IN
National Provider Identifier
1952494411
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20042030A Issued in IN
Practice address
13295 Illinois St Ste 123
Carmel, IN 46032-3020
Phone
(317) 983-1119
Fax
(888) 443-4046
NPI assigned
Oct 2, 2006
Last updated
Sep 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 95000157A IN
Cognitive & Behavioral Psychologist 103TB0200X 20042030A IN
Clinical Child & Adolescent Psychologist 103TC2200X 20042030A IN
Family Psychologist 103TF0000X 20042030A IN
Psychologist 103T00000X 20042030A IN Primary

Addresses

Primary practice location

13295 Illinois St Ste 123
Carmel, IN 46032-3020

Mailing address

13295 Illinois St Ste 123
Carmel, IN 46032-3020
Phone (317) 517-8817

Other practice location 1

8350 Craig Street
Optional
Indianapolis, IN 46250
Phone (317) 517-8817

Other practice location 2

7739 E 88th St
Indianapolis, IN 46256-1231
Phone (317) 517-8817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100201000599 IN Practitioner - Clinical Psychologist 9032277843 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
20042030AINMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Hope Source Inc. Behavior Analyst CurrentSince Oct 8, 2024 Accepting new patients
Momi Yamanaka, PH.D. HSPP LLC. Behavior Analyst PastSince Sep 23, 2021 Accepting new patients

Locations

7739 E 88th St
Indianapolis, IN 46256
Phone (317) 288-4767

8350 Craig St
Indianapolis, IN 46250

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1952494411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13295 ILLINOIS ST STE 123",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323020",
            "telephone_number": "317-517-8817",
            "fax_number": "888-443-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13295 ILLINOIS ST STE 123",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323020",
            "telephone_number": "317-983-1119",
            "fax_number": "888-443-4046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8350 Craig Street",
            "address_2": "Optional",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "46250",
            "country_code": "US",
            "telephone_number": "317-517-8817",
            "fax_number": "888-443-4046",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7739 E 88th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462561231",
            "country_code": "US",
            "telephone_number": "317-517-8817",
            "fax_number": "888-443-4046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAMANAKA",
        "first_name": "MOMI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "95000157A",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IN",
            "license": "20042030A",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IN",
            "license": "20042030A",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "IN",
            "license": "20042030A",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20042030A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.