Samantha Golembiewski, LPC
Individual provider Active NPI Professional Counselor · Walworth, WI
NPI 1124976949 · NPPES record last updated Mar 18, 2026
Key facts
- NPI
- 1124976949
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 178.010735 (IL)
- Practice address
- 124 Phillips Ave
Walworth, WI 53184-9676 - Phone
- (815) 671-1681
- NPI assigned
- Mar 18, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.010735 | IL | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.010735 | IL | Yes |
Addresses
Primary practice location
124 Phillips Ave
Walworth, WI 53184-9676
Mailing address
124 Phillips Ave
Walworth, WI 53184-9676
Phone (815) 671-1681
Other providers in Walworth, WI
- Mary E. Frazier
- Hollyanne George
- Robert M Gerson
- Nathan C Gilling
- Golden Years Nursing Home, Inc.
- Megan R Hopp
- Dale Gary Jacobson
- Victoria Ann Knull
- Bridget Grace Labus
- Lake Geneva Psychology, Inc.
All providers in Walworth, WI · Professional Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.