Individual provider Active NPI

James Michael Sam, PHD. LMSW

  • Clinical Psychologist
  • Port Huron, MI
National Provider Identifier
1306919717
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301009063 Issued in MI
Practice address
1209 Richardson St
Port Huron, MI 48060-3548
Phone
(810) 984-5156
NPI assigned
Nov 15, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401000060 MI
Clinical Psychologist 103TC0700X 6301009063 MI Primary
Clinical Social Worker 1041C0700X 6801032915 MI

Addresses

Primary practice location

1209 Richardson St
Port Huron, MI 48060-3548

Mailing address

9607 River Rd
Clay, MI 48001-4016
Phone (810) 794-7574

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

State licenses

LicenseStateTypeSpecialty
6401000060MIMDProfessional Counselor
6301009063MIMDClinical Psychologist
6801032915MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Port Huron Clinical Past Accepting new patients

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1306919717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9607 RIVER RD",
            "city": "CLAY",
            "state": "MI",
            "postal_code": "480014016",
            "telephone_number": "810-794-7574",
            "fax_number": "810-794-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 RICHARDSON ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603548",
            "telephone_number": "810-984-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAM",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHD. LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401000060",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301009063",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801032915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.