Shafinah Samsudin, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701005338 Issued in VA

Practice address

43676 Trade Center PL Ste 135
Sterling, VA 20166-2124

Phone

(703) 939-7741

Fax

(703) 543-0443

NPI assigned

Apr 12, 2013

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Seek Serenity LLC

  • Mental Health Counselor
  • Sterling, VA
  • NPI 1134648678
  Authorized official Same address or phone

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1346683919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43676 TRADE CENTER PL STE 135",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201662124",
            "telephone_number": "703-939-7741",
            "fax_number": "703-543-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43676 TRADE CENTER PL STE 135",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201662124",
            "telephone_number": "703-939-7741",
            "fax_number": "703-543-0443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46950 Community Plz",
            "address_2": "211",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201641814",
            "country_code": "US",
            "telephone_number": "412-721-9957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "46950 Community Plz",
            "address_2": "211",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201641814",
            "country_code": "US",
            "telephone_number": "412-721-9957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMSUDIN",
        "first_name": "SHAFINAH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710102755",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701005338",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701005338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Sterling, VA
• Providers in Sterling, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.