Ellen Faye Samuelson, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

822 S 3Rd St Ste 100
Minneapolis, MN 55415-1200

Phone

(612) 217-1667

NPI assigned

Mar 8, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• RS Eden

  • Substance Abuse Rehabilitation Facility
  • Minneapolis, MN
  • NPI 1063590214
  NPD (past)

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1144920190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 S 3RD ST STE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151200",
            "telephone_number": "612-217-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 S 3RD ST STE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151200",
            "telephone_number": "612-217-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "ELLEN",
        "middle_name": "FAYE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Lee Samudio, APRN, CNP, DNP
• Robin Marie Samuel, OTR/L
• Caitlin Anne Samuels, MSW, LICSW
• Sarah Jane Howard Samuels, LICSW
• Samuelson Psychotherapy LLC
• Marya Samuelson, M.ED., LPCC
• Ashley Samulenas
• Sana Wellness LLC
• Sajal Sakshi Sanan
• Hassan Sanbul

• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.