Johnetta Sams

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1638 R St NW Ste 314-316
Washington, DC 20009-6446

Phone

(202) 618-0744

Fax

(202) 810-9097

NPI assigned

Apr 28, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Imind Health LLCGroup PAC ID 9537417324, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Imind Health LLC

  dba iMind Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Lanham, MD
  • NPI 1265921647

  DC

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1366187080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 15TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200051502",
            "telephone_number": "202-618-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 R ST NW STE 314-316",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200096446",
            "telephone_number": "202-618-0744",
            "fax_number": "202-810-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMS",
        "first_name": "JOHNETTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH",
            "identifier": "82-5272962",
            "state": "DC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SimplePracticeEHR",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1638 R St NW Ste 314-316",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200096446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julia A Sampson, SLP
• Kesha Sampson
• Priscilla Ann Sampson
• Rongi Sampson
• Thieraldine Sampson
• Eric David Samson, DDS
• Marguerite Samson
• Maria Samson
• Daunett Samuda, NP
• Jeremiah I Samuel, HHA

• Mental Health Counselor in Washington, DC
• Providers in Washington, DC by specialty
• Mental Health Counselor in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.