Individual provider Active NPI

Marcia B Samuels, PSY.D.

  • Clinical Psychologist
  • Norfolk, VA
National Provider Identifier
1073589974
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810002810 Issued in VA
Practice address
249 W York St
Norfolk, VA 23510-1520
Phone
(757) 622-6794
Fax
(757) 626-1509
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810002810 VA Primary

Addresses

Primary practice location

249 W York St
Norfolk, VA 23510-1520

Mailing address

249 W York St
Norfolk, VA 23510-1520
Phone (757) 622-6794

Other identifiers 1

IdentifierTypeStateIssuer
0076022821MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20050118000797 VA Practitioner - Clinical Psychologist 1557310448 Practice locations: Norfolk, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

919 W 21St St
Suite B
Norfolk, VA 23517-1515
Phone (757) 622-6794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0810002810VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Psychological Resources Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073589974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 W YORK ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101520",
            "telephone_number": "757-622-6794",
            "fax_number": "757-626-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 W YORK ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101520",
            "telephone_number": "757-622-6794",
            "fax_number": "757-626-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "MARCIA",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076022821",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.