Active NPI
Samantha Weidele Waldman, LPC
- Professional Counselor
- Waxhaw, NC
National Provider Identifier
1467892109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 9950
- Practice address
- 9929 Rea Rd Ste 201
Waxhaw, NC 28173 - Phone
- (704) 316-1650
- Fax
- (704) 316-1651
- NPI assigned
- Jun 26, 2013
- Last updated
- Oct 26, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 9950 | NC | Primary |
Addresses
Primary practice location
9929 Rea Rd Ste 201
Waxhaw, NC 28173
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-1650
Other practice location 1
1190 W Roosevelt Blvd
Monroe, NC 28110-2818
Phone (704) 296-6200
Other practice location 2
1190 W Roosevelt Blvd
Monroe, NC 28110-2818
Phone (704) 296-6200
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | swaldman739785@direct.novanthealth.org |
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 |
|---|---|---|---|
| 9950 | NC | MD | Physical Therapist |
Interoperability endpoints
- swaldman739785@direct.novanthealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1467892109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447",
"telephone_number": "704-316-1650",
"fax_number": "704-316-1651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9929 REA RD STE 201",
"city": "WAXHAW",
"state": "NC",
"postal_code": "28173",
"telephone_number": "704-316-1650",
"fax_number": "704-316-1651"
}
],
"practiceLocations": [
{
"address_1": "1190 W Roosevelt Blvd",
"address_purpose": "LOCATION",
"city": "Monroe",
"state": "NC",
"postal_code": "281102818",
"country_code": "US",
"telephone_number": "704-296-6200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1190 W Roosevelt Blvd",
"address_purpose": "LOCATION",
"city": "Monroe",
"state": "NC",
"postal_code": "281102818",
"country_code": "US",
"telephone_number": "704-296-6200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALDMAN",
"first_name": "SAMANTHA",
"middle_name": "WEIDELE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-26",
"last_updated": "2020-10-26",
"certification_date": "2020-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "9950",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "swaldman739785@direct.novanthealth.org",
"affiliation": "N",
"address_1": "1190 W Roosevelt Blvd",
"city": "Monroe",
"state": "NC",
"country_code": "US",
"postal_code": "281102818",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Waxhaw, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.