Carly M. Samudre, LPC-MHSP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4607 Issued in TN

Practice address

1604 Westgate Cir Ste 240
Brentwood, TN 37027-8578

Phone

(615) 543-5543

NPI assigned

Apr 1, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Enjoyco, Inc.

  • Mental Health Counselor
  • Brentwood, TN
  • NPI 1508600149
  NPD Authorized official

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1346668993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 LEXIE LN",
            "city": "SPRING HILL",
            "state": "TN",
            "postal_code": "371746590",
            "telephone_number": "410-562-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 WESTGATE CIR STE 240",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370278578",
            "telephone_number": "615-543-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUDRE",
        "first_name": "CARLY",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "LPC-MHSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "4607",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Yvonne Salaksana, APRN
• Munther Saleh
• Inga Salija, BS, CNIM
• Magda Sobhi Salisbury, M.ED, M.A.
• Sreedhar Samudrala, M.D
• Laura Ariana Sanchez
• Laura Wood Sanchez, M.S., CCC-SLP
• Miguel Sanchez
• Maggie Sanders Hood
• Elaina Joy Sanders, BSN, RN

• Mental Health Counselor in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.