Samantha Philo, SACIT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

16581130 Issued in WI

Practice address

4000 W Spencer St
Appleton, WI 54914-4015

Phone

(920) 735-9010

Fax

(920) 735-9050

NPI assigned

Feb 6, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Van Ornum Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1255670501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W SPENCER ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549144015",
            "telephone_number": "920-735-9010",
            "fax_number": "920-735-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W SPENCER ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549144015",
            "telephone_number": "920-735-9010",
            "fax_number": "920-735-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILO",
        "first_name": "SAMANTHA",
        "credential": "SACIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-06",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16581130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "VAN ORNUM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacob T Pflum, CRNA
• Shannon I Pham, NP
• Philip K. Hornseth, D.D.S., S.C.
• Joyce Rachel Philip, M.D.
• Judith L Phillips, RN
• Rebecca J Philpot, APNP
• Trisha Ann Picard, LCSW
• Trisha Megan Pichoch, DDS
• Benjamin J Pickart, HIS
• Sharon R Pieper, COTA

• Addiction (Substance Use Disorder) Counselor in Appleton, WI
• Providers in Appleton, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.