Active NPI
Sean Eric Samuels, PSY.D.
- Psychologist
- Lincoln, NE
National Provider Identifier
1215969514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 624
- Practice address
- 4545 S 86TH St
Lincoln, NE 68526-9227 - Phone
- (402) 483-6990
- Fax
- (402) 483-7045
- NPI assigned
- Jul 7, 2006
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 624 | NE | |
| Psychologist | 103T00000X | 624 | NE | Primary |
| Clinical Psychologist | 103TC0700X | 624 | NE | |
| Forensic Psychologist | 103TF0200X | 624 | NE |
Addresses
Primary practice location
4545 S 86TH St
Lincoln, NE 68526-9227
Mailing address
4545 S 86TH St
Lincoln, NE 68526-9227
Phone (402) 483-6990
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10024969000 | Medicaid | NE | |
| 47079871700 | Medicaid | NE | |
| 10024968900 | Medicaid | NE | |
| 470798717-26 | Medicaid | NE | |
| 470798717-27 | Medicaid | NE | |
| 470798717-29 | Medicaid | NE | |
| 246565 | Other | NE | MIDLANDS CHOICE |
| D80001 | Other | NE | BCBS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 231 | NE | MD | Addiction (Substance Use Disorder) Counselor |
| 624 | NE | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1215969514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4545 S 86TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685269227",
"telephone_number": "402-483-6990",
"fax_number": "402-483-7045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4545 S 86TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685269227",
"telephone_number": "402-483-6990",
"fax_number": "402-483-7045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELS",
"first_name": "SEAN",
"middle_name": "ERIC",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NE",
"license": "624",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NE",
"license": "624",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NE",
"license": "624",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "NE",
"license": "624",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10024969000",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47079871700",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10024968900",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470798717-26",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470798717-27",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470798717-29",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "246565",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "D80001",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.