Active NPI
Samantha Bryan, CDCA
- Case Manager/Care Coordinator
- Chesapeake, OH
National Provider Identifier
1124810049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 303 3Rd Ave
Chesapeake, OH 45619-1144 - Phone
- (740) 451-0415
- Fax
- (800) 480-7578
- NPI assigned
- May 19, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.192400 | OH | |
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
303 3Rd Ave
Chesapeake, OH 45619-1144
Mailing address
1216 Monroe Ave
Huntington, WV 25704-2438
Phone (304) 964-4615
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0127415 | Medicaid | OH |
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 |
|---|---|---|---|
| CDCA.192400 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regal Recovery Care, LLC | Current | Accepting new patients | |
| Regal Recovery Care, LLC | Current | Accepting new patients |
Locations
7955 County Road 107
Ste B
Proctorville, OH 45669
Phone (740) 523-0097
520 Solida Rd
South Point, OH 45680
Phone (740) 523-0097
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Proctorville, OH
- NPI 1346077070
-
- Community/Behavioral Health Agency
- Proctorville, OH
- NPI 1508500612
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763942400000",
"number": "1124810049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1216 MONROE AVE",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257042438",
"telephone_number": "304-964-4615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 3RD AVE",
"city": "CHESAPEAKE",
"state": "OH",
"postal_code": "456191144",
"telephone_number": "740-451-0415",
"fax_number": "800-480-7578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYAN",
"first_name": "SAMANTHA",
"credential": "CDCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-19",
"last_updated": "2025-11-24",
"certification_date": "2025-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.192400",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0127415",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chesapeake, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.