Samantha Wisneski
Individual provider Active NPI Counselor · Ferndale, MI
NPI 1144985474 · NPPES record last updated Dec 30, 2024
Key facts
- NPI
- 1144985474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 6401224677 (MI)
- Practice address
- 3178 Hilton Rd
Ferndale, MI 48220-1059 - Phone
- (248) 629-4600
- NPI assigned
- Nov 2, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401224677 | MI | Yes |
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
Other providers in Ferndale, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2024. 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.