Individual provider Active NPI

Samantha Elizabeth Mevorach, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Los Angeles, CA
National Provider Identifier
1497399042
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP35551 Issued in CA
Practice address
12304 Santa Monica Blvd Ste 364
Los Angeles, CA 90025-1542
Phone
(310) 270-6597
NPI assigned
Nov 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SI4023 FL
Speech-Language Pathologist 235Z00000X SP35551 CA Primary

Addresses

Primary practice location

12304 Santa Monica Blvd Ste 364
Los Angeles, CA 90025-1542

Mailing address

9901 Washington Blvd
Culver City, CA 90232-2756
Phone (516) 987-4463

Other practice location 1

2023 S Westgate Ave
Los Angeles, CA 90025-6118
Phone (310) 899-9597

Other practice location 2

315 NE 10th Ave
Crystal River, FL 34429-4456
Phone (352) 795-7006

Other practice location 3

315 NE 10th Ave
Crystal River, FL 34429-4456
Phone (352) 795-7006

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SI4023FLMDSpeech-Language Assistant
SP35551CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Child Success Center Speech-Language Pathologist CurrentSince Sep 3, 2025 Accepting new patients
Superior Therapy Services Inc Speech-Language Pathologist CurrentSince Nov 7, 2020 Accepting new patients

Locations

2023 S Westgate Ave
Los Angeles, CA 90025
Phone (310) 899-9597

315 NE 10th Ave
Crystal River, FL 34429
Phone (352) 795-7006

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": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1497399042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 WASHINGTON BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322756",
            "telephone_number": "516-987-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12304 SANTA MONICA BLVD STE 364",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251542",
            "telephone_number": "310-270-6597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2023 S Westgate Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900256118",
            "country_code": "US",
            "telephone_number": "310-899-9597",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 NE 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Crystal River",
            "state": "FL",
            "postal_code": "344294456",
            "country_code": "US",
            "telephone_number": "352-795-7006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 NE 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Crystal River",
            "state": "FL",
            "postal_code": "344294456",
            "country_code": "US",
            "telephone_number": "352-795-7006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEVORACH",
        "first_name": "SAMANTHA",
        "middle_name": "ELIZABETH",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-06",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI4023",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP35551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.