Samuel Ntrakwa, MPH, M.DIV

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

8111 Grand Ave Apt 3S
River Grove, IL 60171-1556

Phone

(706) 294-3946

NPI assigned

Feb 14, 2024

Last updated

Feb 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1033974548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8111 GRAND AVE APT 3S",
            "city": "RIVER GROVE",
            "state": "IL",
            "postal_code": "601711556",
            "telephone_number": "706-294-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 GRAND AVE APT 3S",
            "city": "RIVER GROVE",
            "state": "IL",
            "postal_code": "601711556",
            "telephone_number": "706-294-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NTRAKWA",
        "first_name": "SAMUEL",
        "credential": "MPH, M.DIV",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grant Thomas Miller, OD
• Nicholas Milosch, PT, DPT
• Nataliya Mostovyy, FNP-BC
• Paul Anthony Naujokas, PT,DPT
• Jenna Nguyen
• Laurie Ann Parsons, LCSW
• Neil Christian President
• Jenna Lynn Quinn, LCSW
• Maureen Diane Ramirez, M.S., CCC-SLP/L
• Kristina Rasums, PT

• Mental Health Counselor in River Grove, IL
• Providers in River Grove, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.