Active NPI
Samuel Daily, LPC, CCTP
- Professional Counselor
- Fayetteville, AR
National Provider Identifier
1154700664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P1209086
- Practice address
- 28 W Sunbridge Dr
Fayetteville, AR 72703 - Phone
- (479) 301-2284
- Fax
- (479) 301-2338
- NPI assigned
- May 29, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | P1209086 | AR | Primary |
Addresses
Primary practice location
28 W Sunbridge Dr
Fayetteville, AR 72703
Mailing address
28 W Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 301-2284
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 |
|---|---|---|---|
| P1209086 | AR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652054400000",
"number": "1154700664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 W SUNBRIDGE DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "72703",
"telephone_number": "479-301-2284",
"fax_number": "479-301-2338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 W SUNBRIDGE DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "72703",
"telephone_number": "479-301-2284",
"fax_number": "479-301-2338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAILY",
"first_name": "SAMUEL",
"credential": "LPC, CCTP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-29",
"last_updated": "2022-05-09",
"certification_date": "2022-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P1209086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.