Active NPI
Samaria M Lewis
- Professional Counselor
- Brentwood, TN
National Provider Identifier
1104486042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701007745
- Practice address
- 5500 Maryland Way Ste 120
Brentwood, TN 37027-4993 - Phone
- (804) 787-2551
- NPI assigned
- Jun 13, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701007745 | VA | Primary |
Addresses
Primary practice location
5500 Maryland Way Ste 120
Brentwood, TN 37027-4993
Mailing address
4121 Cameron Rd
Hopewell, VA 23860-1670
Phone (434) 378-1306
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0701007745 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guiding Lives, Inc | 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.
-
- Mental Health Counselor
- Hopewell, VA
- NPI 1528339231
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660089600000",
"number": "1104486042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4121 CAMERON RD",
"city": "HOPEWELL",
"state": "VA",
"postal_code": "238601670",
"telephone_number": "434-378-1306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 MARYLAND WAY STE 120",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370274993",
"telephone_number": "804-787-2551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "SAMARIA",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-13",
"last_updated": "2022-08-10",
"certification_date": "2022-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701007745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.