Brisa S Samudio, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

29644 Issued in CA

Practice address

5587 Murray Ave Ste 205
Memphis, TN 38119-0896

Phone

(310) 879-5554

NPI assigned

Oct 8, 2010

Last updated

Sep 24, 2019By 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

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

• E3 Community Health/ Engage. Educate. Empower. Community Health

  • Community/Behavioral Health Agency
  • Memphis, TN
  • NPI 1366002305
  NPD Authorized official
• Samara Center, PLLC

  • Clinical Social Worker
  • Memphis, TN
  • NPI 1356992051
  NPD Authorized official
• Samara Foundation

  • Social Worker
  • Memphis, TN
  • NPI 1992587745
  NPD Authorized official

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1366752347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5587 MURRAY AVE STE 205",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190896",
            "telephone_number": "310-879-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5587 MURRAY AVE STE 205",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190896",
            "telephone_number": "310-879-5554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5200 Lankershim Blvd",
            "address_2": "Suite 170",
            "address_purpose": "LOCATION",
            "city": "North Hollywood",
            "state": "CA",
            "postal_code": "916013155",
            "country_code": "US",
            "telephone_number": "818-980-3200",
            "fax_number": "818-980-3203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUDIO",
        "first_name": "BRISA",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-08",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "29644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sams East Inc (Sams Pharmacy 10-6256)
• Sams East Inc (Sams Pharmacy 10-8292)
• Shannon Samsa
• Christina Regan Samson
• Jacques E Samson, M.D.
• Camryn Samuel
• Danelly J Samuel, MD
• Vincent K. Samuel, M.D.
• Nayeli Sanchez Nevarez, DMD
• Kristal Sanchez Olivares

• Mental Health Counselor in Memphis, TN
• Providers in Memphis, 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 Sep 24, 2019; 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.