Active NPI
Samantha Inez Ambrico-Custer, LPC-A
- Counselor
- West Chester, PA
National Provider Identifier
1346083078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- APC000130
- Practice address
- 103 S High St
West Chester, PA 19382-3262 - Phone
- (484) 222-8697
- NPI assigned
- Jun 18, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | APC000130 | PA | Primary |
Addresses
Primary practice location
103 S High St
West Chester, PA 19382-3262
Mailing address
603 Naylors Run Rd
Havertown, PA 19083-4521
Phone (631) 807-5249
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
| License | State | Type | Specialty |
|---|---|---|---|
| APC000130 | PA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1346083078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 NAYLORS RUN RD",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190834521",
"telephone_number": "631-807-5249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 S HIGH ST",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193823262",
"telephone_number": "484-222-8697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBRICO-CUSTER",
"first_name": "SAMANTHA",
"middle_name": "INEZ",
"name_prefix": "Ms.",
"credential": "LPC-A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-18",
"last_updated": "2024-06-18",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "PA",
"license": "APC000130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Chester, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.