Shackola Samantha Symons, LMHC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

006456-1 Issued in NY

Practice address

481 Main St
New Rochelle, NY 10801-6324

Phone

(914) 355-2440

NPI assigned

Oct 14, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shackolasymons@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NY

  Medicare reassignment NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1507939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507939200000",
    "number": "1255842464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 S 4TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504132",
            "telephone_number": "718-614-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 MAIN ST",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108016324",
            "telephone_number": "914-355-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYMONS",
        "first_name": "SHACKOLA",
        "middle_name": "SAMANTHA",
        "credential": "LMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-14",
        "last_updated": "2017-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "006456-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Swanko, LMHC, CASAC-2
• Gary David Swergold, MD
• Nathaniel Cuthbert Swinburne, M.D.
• Ali Swoish, LMHC
• Sycamore Haven Mental Health Counseling, PLLC
• Sarah Tabet, NP
• Sanford L Taffet, M.D.
• Myrna Tahhan, SPEECH PATHOLAGIST
• Tomoko Takano, MA
• Rori Tamagna

• Mental Health Counselor in New Rochelle, NY
• Providers in New Rochelle, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.