Individual provider Active NPI

Samantha Jo Floersch

  • Addiction (Substance Use Disorder) Counselor
  • Seattle, WA
National Provider Identifier
1033729785
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP61210985 Issued in WA
Practice address
1202 E Pine St
Seattle, WA 98122-3929
Phone
(206) 649-5081
Fax
(612) 870-6143
NPI assigned
Aug 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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 305771 MN
Addiction (Substance Use Disorder) Counselor 101YA0400X CP61210985 WA Primary

Addresses

Primary practice location

1202 E Pine St
Seattle, WA 98122-3929

Mailing address

1526 192ND St SE Apt Q3
Bothell, WA 98012-6896
Phone (612) 388-5553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
305771MNMDAddiction (Substance Use Disorder) Counselor
CP61210985WAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1033729785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 192ND ST SE APT Q3",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980126896",
            "telephone_number": "612-388-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E PINE ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981223929",
            "telephone_number": "206-649-5081",
            "fax_number": "612-870-6143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOERSCH",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305771",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP61210985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.