Individual provider Active NPI

Samantha Lynn Ribbentrop, LCSW

  • Mental Health Counselor
  • Boca Raton, FL
National Provider Identifier
1053826404
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW14961 Issued in FL
Practice address
777 Glades Road
SSB-8 Room 229
Boca Raton, FL 33431
Phone
(561) 297-3540
NPI assigned
Dec 7, 2017
Last updated
Oct 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SW14961 FL Primary

Addresses

Primary practice location

777 Glades Road
SSB-8 Room 229
Boca Raton, FL 33431

Mailing address

777 Glades Road
SSB-8 Room 229
Boca Raton, FL 33431-6424
Phone (561) 297-3540

Other practice location 1

2014 Alta Meadows Ln
Delray Beach, FL 33444-1110
Phone (703) 508-4377

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
SW14961FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1053826404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 GLADES ROAD",
            "address_2": "SSB-8 ROOM 229",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316424",
            "telephone_number": "561-297-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 GLADES ROAD",
            "address_2": "SSB-8 ROOM 229",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33431",
            "telephone_number": "561-297-3540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2014 Alta Meadows Ln",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334441110",
            "country_code": "US",
            "telephone_number": "703-508-4377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIBBENTROP",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-07",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW14961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.