Alexa Amelia Samuelson

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

2233 Nesconset Hwy Ste 201
Lake Grove, NY 11755-1000

Phone

(631) 786-8930

Fax

(631) 256-5229

NPI assigned

May 23, 2023

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Conscious Psychotherapy LCSW PC

  • Clinical Social Worker
  • East Setauket, NY
  • NPI 1912601725
  NPD
• South Shore Psychological Care P.C.

  • Clinical Psychologist
  • East Moriches, NY
  • NPI 1144559881
  NPD

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1336831817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34A N COUNTRY RD",
            "city": "MOUNT SINAI",
            "state": "NY",
            "postal_code": "117661528",
            "telephone_number": "631-942-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 NESCONSET HWY STE 201",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551000",
            "telephone_number": "631-786-8930",
            "fax_number": "631-256-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "ALEXA",
        "middle_name": "AMELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Marie Witek RN,BSN
• Alyssa Ruggiero, MHC LP
• Alexandra Saar, PA-C
• Sachem Central School District
• Kaitlyn Sampler, CRPA
• Christopher Savini
• Nicole Christin Scala
• Theresa Scarola, LCSW
• Barry Schlactus, O.D.
• Barry Craig Schlesinger, D.C.

• Marriage & Family Therapist in Lake Grove, NY
• Providers in Lake Grove, NY by specialty
• Marriage & Family Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.