Active NPI
Samantha Wisneski
- Counselor
- Ferndale, MI
National Provider Identifier
1144985474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401224677
- Practice address
- 3178 Hilton Rd
Ferndale, MI 48220-1059 - Phone
- (248) 629-4600
- NPI assigned
- Nov 2, 2021
- Last updated
- Dec 30, 2024
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401224677 | MI | Primary |
Addresses
Primary practice location
3178 Hilton Rd
Ferndale, MI 48220-1059
Mailing address
625 S Marias Ave
Clawson, MI 48017-1892
Other practice location 1
42450 Hayes Rd Ste 3A
Clinton Township, MI 48038-6769
Phone (248) 629-4600
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 |
|---|---|---|---|
| 6401224677 | MI | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifelab Kids Foundation | Mental Health | Current | Accepting new patients |
| Maples Creative Counseling LLC | Counselor | Past | Accepting new patients |
Locations
3178 Hilton Rd
Ferndale, MI 48220
Phone (248) 331-2744
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Embrace Change Therapy
- Community/Behavioral Health Agency
- Troy, MI
- NPI 1285125823
Counselor
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735516800000",
"number": "1144985474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 S MARIAS AVE",
"city": "CLAWSON",
"state": "MI",
"postal_code": "480171892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3178 HILTON RD",
"city": "FERNDALE",
"state": "MI",
"postal_code": "482201059",
"telephone_number": "248-629-4600"
}
],
"practiceLocations": [
{
"address_1": "42450 Hayes Rd Ste 3A",
"address_purpose": "LOCATION",
"city": "Clinton Township",
"state": "MI",
"postal_code": "480386769",
"country_code": "US",
"telephone_number": "248-629-4600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WISNESKI",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-02",
"last_updated": "2024-12-30",
"certification_date": "2024-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401224677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ferndale, MI
- Willow Tree Wellness PLLC
- Theresa Ann Wills, FNP-BC
- Deneen Renee Winans, DPT, OMPT, CSCS
- Wingate Wound Care PLLC
- Jeffrey K Wingate, MD
- With Love Home Help Care Services
- Wonderfully Made Women's Health Care
- Woodward Detroit CVS, L.L.C. (CVS Pharmacy #08180)
- Woodward Detroit CVS, L.L.C. (CVS Pharmacy #08101)
- Morgan Kim Woolfolk, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.