Maryann Samuel, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 24440 Issued in CA

Practice address

25255 Cabot Rd
Suite #210
Laguna Hills, CA 92653-5519

Phone

(949) 887-8779

NPI assigned

Oct 13, 2011

Last updated

Jan 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Maryann Henein Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Samuel Psychotherapy, Inc

  • Psychologist
  • Laguna Hills, CA
  • NPI 1316333636
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1033494703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 ARGONAUT STE 245",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926564129",
            "telephone_number": "949-887-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25255 CABOT RD",
            "address_2": "SUITE #210",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535519",
            "telephone_number": "949-887-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "MARYANN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 24440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYANN",
            "last_name": "HENEIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alicia Salyer
• Michael Clarence Salzle
• Samantha de Leon Tillapaugh DDS Inc. (Reset Studio)
• Kara Samoff
• Samuel Psychotherapy, Inc
• Fernando Sanchez Robles
• Adam F Sanchez, OTR/L
• Angie Nataly Sanchez
• Leslie Denise Sanchez
• Ana Sandoval

• Psychologist in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.