Individual provider Active NPI

Alice Samuel, MA

  • Mental Health Counselor
  • Saint Paul, MN
National Provider Identifier
1497475933
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2230 Como Ave
Saint Paul, MN 55108-1720
Phone
(651) 645-5323
NPI assigned
Sep 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2230 Como Ave
Saint Paul, MN 55108-1720

Mailing address

2265 Como Ave
Saint Paul, MN 55108-1737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240813002179 MN Practitioner - Clinical Psychologist 8325586035 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Program P C CurrentSince May 30, 2024 Accepting new patients
Lorenz Clinic, LLC CurrentSince Mar 10, 2025 Accepting new patients

Locations

1435 White Oak Dr
Ste 200
Chaska, MN 55318
Phone (651) 374-1470

1295 Bandana Blvd N
Ste 210
Saint Paul, MN 55108
Phone (888) 272-0784

2230 Como Ave
Saint Paul, MN 55108
Phone (651) 635-0095

2265 Como Ave
Saint Paul, MN 55108

1772 Stieger Lake Ln
Ste 220
Victoria, MN 55386
Phone (763) 443-4600

Interoperability endpoints

  • Direct secure messaging: alice.samuel.1@16506.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/16506/brand/1/csg/1/fhir/r4

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": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1497475933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081720",
            "telephone_number": "651-645-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "ALICE",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.