Individual provider Active NPI

Mavis N Tah Sama, HHA, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mechanicsville, VA
National Provider Identifier
1073855490
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024191310 Issued in VA
Practice address
9202 Center Oak CT
Mechanicsville, VA 23116-2744
Phone
(804) 207-6737
NPI assigned
Mar 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024191310 VA Primary

Addresses

Primary practice location

9202 Center Oak CT
Mechanicsville, VA 23116-2744

Mailing address

9202 Center Oak CT
Mechanicsville, VA 23116-2744
Phone (804) 207-6737

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241219003113 VA Practitioner - Nurse Practitioner 5395272058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

Practice addresses (Care Compare)

9202 Ctr Oak CT
Mechanicsville, VA 23116-2744
Phone (804) 207-6737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Physicians PC CurrentSince Dec 1, 2024 Accepting new patients
Commonwealth Counseling Associates Inc Psychiatric/Mental Health CurrentSince Oct 1, 2025 Accepting new patients

Locations

9202 Center Oak Ct
Mechanicsvlle, VA 23116
Phone (804) 639-1112

804 Moorefield Park Dr
Ste 108
North Chesterfield, VA 23236
Phone (804) 323-8282

2810 N Parham Rd
Ste 120
Richmond, VA 23294

2621 Grove Ave
Richmond, VA 23220
Phone (804) 252-5433

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.mavistahsama@134000.advancedmd-direct.com

Organizations & group practices 2

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": "1364083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1073855490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9202 CENTER OAK CT",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162744",
            "telephone_number": "804-207-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9202 CENTER OAK CT",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162744",
            "telephone_number": "804-207-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAH SAMA",
        "first_name": "MAVIS",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "HHA, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-24",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024191310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

Verify at the official NPI Registry.