Individual provider Active NPI

Amber Rei Samson, M.S.

  • Professional Counselor
  • Hyattsville, MD
National Provider Identifier
1265971139
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LGP8989 Issued in MD
Practice address
7212 Clagett Dr
Hyattsville, MD 20785-1972
Phone
(630) 217-4698
NPI assigned
Feb 13, 2017
Reactivated
Mar 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X LGP8989 MD Primary

Addresses

Primary practice location

7212 Clagett Dr
Hyattsville, MD 20785-1972

Mailing address

7212 Clagett Dr
Hyattsville, MD 20785-1972
Phone (630) 217-4698

Other identifiers 1

IdentifierTypeStateIssuer
38-3876389MedicaidMD

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LGP8989MDMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1265971139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 CLAGETT DR",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207851972",
            "telephone_number": "630-217-4698",
            "fax_number": "443-773-5624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7212 CLAGETT DR",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207851972",
            "telephone_number": "630-217-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "AMBER",
        "middle_name": "REI",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "deactivation_date": "2024-02-28",
        "reactivation_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP8989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38-3876389",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.