Individual provider Active NPI

Paula Kay Bibbs-Samuels, LPC

  • Professional Counselor
  • Lubbock, TX
National Provider Identifier
1235801226
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
81777 Issued in TX
Practice address
5701 Avenue P
Lubbock, TX 79412-3674
Phone
(806) 747-3488
Fax
(806) 747-3219
NPI assigned
Sep 29, 2021
Last updated
Jan 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 81777 TX Primary

Addresses

Primary practice location

5701 Avenue P
Lubbock, TX 79412-3674

Mailing address

805 S Ivory St
Slaton, TX 79364-5740
Phone (806) 790-6776

Other practice location 1

3601 4th St Ste 3A251
Lubbock, TX 79430-3674
Phone (806) 743-9831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240524000012 TX Practitioner - Mental Health Counselor 1254773013 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81777TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Assn of Lubbock, Texas, Inc. CurrentSince Mar 28, 2024 Accepting new patients

Locations

5701 Avenue P
Lubbock, TX 79412
Phone (806) 741-0713

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1235801226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 S IVORY ST",
            "city": "SLATON",
            "state": "TX",
            "postal_code": "793645740",
            "telephone_number": "806-790-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 AVENUE P",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794123674",
            "telephone_number": "806-747-3488",
            "fax_number": "806-747-3219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St Ste 3A251",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794303674",
            "country_code": "US",
            "telephone_number": "806-743-9831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIBBS-SAMUELS",
        "first_name": "PAULA",
        "middle_name": "KAY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "81777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.