Individual provider Active NPI

Tonya Denise Samuels, LMFT

  • Marriage & Family Therapist
  • Clermont, FL
National Provider Identifier
1447855432
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT001805 Issued in GA
Practice address
210 N Highway 27 Ste 4
Clermont, FL 34711-2411
Phone
(352) 708-6283
NPI assigned
Nov 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT001805 GA Primary

Addresses

Primary practice location

210 N Highway 27 Ste 4
Clermont, FL 34711-2411

Mailing address

1557 Branden Way
Richmond Hill, GA 31324-6285
Phone (912) 549-0309

Other practice location 1

1557 Branden Way
Richmond Hill, GA 31324-6285
Phone (912) 549-0309

Other practice location 2

858 S Duncan Dr
Tavares, FL 32778-4044
Phone (352) 708-6283

Other practice location 3

9100 Conroy Windermere Rd Ste 206
Windermere, FL 34786-8431
Phone (352) 708-6283

Other practice location 4

1965 S Orange Blossom Trl
Apopka, FL 32703-7757
Phone (352) 708-6283

Other practice location 5

100 S Kentucky Ave
Lakeland, FL 33801-5096
Phone (352) 708-6283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20240320004274 FL Practitioner - Marriage and Family Therapist 3577900968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Life Counseling CenterGroup PAC ID 0648623835, 13 clinicians

Practice addresses (Care Compare)

210 N Hwy 27
Suite 4
Clermont, FL 34711-2411
Phone (352) 708-6283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFT001805GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Life Counseling Center Marriage & Family Therapist CurrentSince Mar 1, 2024 Accepting new patients
Pillars of Hope Counseling Services, LLC. CurrentSince Dec 27, 2020 Accepting new patients

Locations

1965 S Orange Blossom Trl
Apopka, FL 32703
Phone (352) 462-0539

210 N US Highway 27
Ste 4
Clermont, FL 34711
Phone (352) 243-4800

100 S Kentucky Ave
Lakeland, FL 33801
Phone (352) 708-6283

858 S Duncan Dr
Tavares, FL 32778
Phone (352) 708-6283

9100 Conroy Windermere Rd
Ste 206
Windermere, FL 34786
Phone (352) 708-6283

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1447855432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 BRANDEN WAY",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313246285",
            "telephone_number": "912-549-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N HIGHWAY 27 STE 4",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112411",
            "telephone_number": "352-708-6283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1557 Branden Way",
            "address_purpose": "LOCATION",
            "city": "Richmond Hill",
            "state": "GA",
            "postal_code": "313246285",
            "country_code": "US",
            "telephone_number": "912-549-0309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "858 S Duncan Dr",
            "address_purpose": "LOCATION",
            "city": "Tavares",
            "state": "FL",
            "postal_code": "327784044",
            "country_code": "US",
            "telephone_number": "352-708-6283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9100 Conroy Windermere Rd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Windermere",
            "state": "FL",
            "postal_code": "347868431",
            "country_code": "US",
            "telephone_number": "352-708-6283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1965 S Orange Blossom Trl",
            "address_purpose": "LOCATION",
            "city": "Apopka",
            "state": "FL",
            "postal_code": "327037757",
            "country_code": "US",
            "telephone_number": "352-708-6283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 S Kentucky Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338015096",
            "country_code": "US",
            "telephone_number": "352-708-6283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "TONYA",
        "middle_name": "DENISE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.