Individual provider Active NPI

Samantha Russell-Porte

  • Marriage & Family Therapist
  • Jacksonville, NC
National Provider Identifier
1285351510
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0717001958 Issued in VA
Practice address
519 Black Pearl Cir
Jacksonville, NC 28546-0157
Phone
(571) 535-4655
NPI assigned
Oct 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0717001958 VA Primary

Addresses

Primary practice location

519 Black Pearl Cir
Jacksonville, NC 28546-0157

Mailing address

519 Black Pearl Cir
Jacksonville, NC 28546-0157

Other practice location 1

9625 Surveyor Ct Ste 200
Manassas, VA 20110-4408
Phone (703) 574-8232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250918001932 VA Practitioner - Marriage and Family Therapist 2365946738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All of You Counseling PCGroup PAC ID 2961904891, 4 clinicians

Practice addresses (Care Compare)

9625 Surveyor CT
Suite 200
Manassas, VA 20110-4408
Phone (703) 574-8232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
All of You Counseling, P.C. Marriage & Family Therapist CurrentSince Jun 1, 2025 Accepting new patients

Locations

9625 Surveyor Ct
Ste 200
Manassas, VA 20110
Phone (703) 330-9933

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1285351510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 BLACK PEARL CIR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285460157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 BLACK PEARL CIR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285460157",
            "telephone_number": "571-535-4655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9625 Surveyor Ct Ste 200",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201104408",
            "country_code": "US",
            "telephone_number": "703-574-8232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL-PORTE",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.