Individual provider Active NPI

Samantha Jean Pelkey-Flock, LPC

  • Professional Counselor
  • Middletown, CT
National Provider Identifier
1316456239
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
46.004601 Issued in CT
Practice address
769 Newfield St Ste 9B
Middletown, CT 06457-1846
Phone
(203) 605-6902
Fax
(833) 301-2087
NPI assigned
Sep 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X
Professional Counselor 101YP2500X 46.004601 CT Primary

Addresses

Primary practice location

769 Newfield St Ste 9B
Middletown, CT 06457-1846

Mailing address

232 Bailey Rd
Middletown, CT 06457-2012
Phone (203) 605-6902

Other names 1

  • Samantha Jean Pelkey Former name

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
46.004601CTMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1316456239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 BAILEY RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572012",
            "telephone_number": "203-605-6902",
            "fax_number": "833-301-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 NEWFIELD ST STE 9B",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064571846",
            "telephone_number": "203-605-6902",
            "fax_number": "833-301-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELKEY-FLOCK",
        "first_name": "SAMANTHA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "46.004601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "PELKEY",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.