Samantha L Charbonneau PA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MT2058 Issued in FL

Legal business name

SAMANTHA L CHARBONNEAU PA

Practice address

101 Timberlachen Cir Ste 201
Lake Mary, FL 32746-6124

Phone

(407) 466-3467

Fax

(407) 549-5987

NPI assigned

May 11, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Samantha Lynn Charbonneau, LMFT

Title

Marriage and Family Therapist

Phone

(407) 466-3467

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1356878128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 TIMBERLACHEN CIR STE 201",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466124",
            "telephone_number": "407-466-3467",
            "fax_number": "407-549-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 TIMBERLACHEN CIR STE 201",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466124",
            "telephone_number": "407-466-3467",
            "fax_number": "407-549-5987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMANTHA L CHARBONNEAU PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "CHARBONNEAU",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MARRIAGE AND FAMILY THERAPIST",
        "authorized_official_telephone_number": "407-466-3467",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT2058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1982634275",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Salkaus, LMHC
• Michelle Ann Salomon, LMHC, NCC
• Beth Ann Salter, LCMHC, LCAS
• Saltzman, Tanis, Pittell, Levin and Jacobson, LLC
• Regina Samaan
• Nadia Samara
• Priya Bakiaseeli Samraj
• Cassandra Deanna Sams, LPC, LMHC
• Chanakay 407.915.7720 Samuels
• Maria Raquel Sanchez Talavera

• Marriage & Family Therapist in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.