Individual provider Active NPI

Samantha Bohr, LPC

  • Professional Counselor
  • Moon Township, PA
National Provider Identifier
1114693058
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC013549 Issued in PA
Practice address
1010 Brodhead Rd
Moon Township, PA 15108-2322
Phone
(412) 339-1782
NPI assigned
Aug 20, 2021
Last updated
Oct 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC013549 PA Primary
Marriage & Family Therapist 106H00000X PC013549 PA

Addresses

Primary practice location

1010 Brodhead Rd
Moon Township, PA 15108-2322

Mailing address

503 Rosecliff Rd
Wexford, PA 15090-1513
Phone (412) 297-1843

Other practice location 1

105 Maple Dr
Warrendale, PA 15086-7590
Phone (412) 339-1782

Other identifiers 1

IdentifierTypeStateIssuer
1042599860002MedicaidPA

Other names 1

  • Samantha's Peaceful Pathways LLC Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250826005195 PA Practitioner - Mental Health Counselor 4789184342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Favored Wellness Counseling and Consulting, LLCGroup PAC ID 2769994805, 11 clinicians

Practice addresses (Care Compare)

1010 Brodhead Rd
Moon Township, PA 15108-2322
Phone (412) 339-1782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Favored Wellness Counseling and Consulting, LLC Professional CurrentSince Jul 10, 2025 Accepting new patients
Crawford County Drug & Alcohol Executive Commission, Inc. PastSince Aug 1, 2021 Accepting new patients
Red Apple Nutrition, LLC Multi-Specialty PastSince Oct 10, 2005 Accepting new patients

Locations

1010 Brodhead Rd
Moon Township, PA 15108
Phone (412) 339-1782

105 Maple Dr
Warrendale, PA 15086
Phone (412) 339-1782

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1114693058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 ROSECLIFF RD",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150901513",
            "telephone_number": "412-297-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 BRODHEAD RD",
            "city": "MOON TOWNSHIP",
            "state": "PA",
            "postal_code": "151082322",
            "telephone_number": "412-339-1782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Maple Dr",
            "address_purpose": "LOCATION",
            "city": "Warrendale",
            "state": "PA",
            "postal_code": "150867590",
            "country_code": "US",
            "telephone_number": "412-339-1782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHR",
        "first_name": "SAMANTHA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC013549",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "PC013549",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1042599860002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA'S PEACEFUL PATHWAYS",
            "last_name": "LLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Moon Township, PA

Sources for this page

Verify at the official NPI Registry.