Samantha Swafford, MS, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3540 Issued in MN

Practice address

10000 Hwy 55 Ste 300
Plymouth, MN 55441-6389

Phone

(763) 412-0722

Fax

(763) 600-6707

NPI assigned

Oct 21, 2022

Last updated

Oct 21, 2022By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Affinity Psychological Services, P.C.

  • Mental Health Counselor
  • Edina, MN
  • NPI 1245610856
  NPD

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1356068217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 HWY 55 STE 300",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416389",
            "telephone_number": "763-412-0722",
            "fax_number": "763-600-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 HWY 55 STE 300",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416389",
            "telephone_number": "763-412-0722",
            "fax_number": "763-600-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAFFORD",
        "first_name": "SAMANTHA",
        "credential": "MS, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "3540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Supervalu Pharmacies Inc (Cub Pharmacy)
• Supervalu Pharmacies Inc (Cub Pharmacy)
• Susan Junis Licsw, LLC
• Samuel Lewis Sutton, MD
• Pauline April Svare, MA, LMFT
• Brennan Patrick Swan, PT, DPT
• Thomas T Swan, MD
• Dawn Marie Swanson
• Emily Swanson
• Kathleen Gail Swanson, D.D.S.

• Mental Health Counselor in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.