Active NPI
Diane Samuels, LMFT
- Marriage & Family Therapist
- West Hartford, CT
National Provider Identifier
1447554183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 001410
- Practice address
- 12 N Main St Ste 10
West Hartford, CT 06107-1936 - Phone
- (869) 841-0169
- NPI assigned
- Jan 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 001410 | CT | Primary |
Addresses
Primary practice location
12 N Main St Ste 10
West Hartford, CT 06107-1936
Mailing address
29 Pheasant Chase
West Hartford, CT 06117
Phone (860) 841-0169
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001410 | CT | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317686400000",
"number": "1447554183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 PHEASANT CHASE",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "06117",
"telephone_number": "860-841-0169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 N MAIN ST STE 10",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061071936",
"telephone_number": "869-841-0169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELS",
"first_name": "DIANE",
"name_prefix": "Ms.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-10",
"last_updated": "2011-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "001410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.