Samantha Ann Nelson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4101006817 Issued in MI

Practice address

6598 Brush St
North Branch, MI 48461-8842

Phone

(810) 610-9277

NPI assigned

Feb 21, 2019

Last updated

Feb 21, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1518424936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9414 FULMER RD",
            "city": "MILLINGTON",
            "state": "MI",
            "postal_code": "487469703",
            "telephone_number": "810-610-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6598 BRUSH ST",
            "city": "NORTH BRANCH",
            "state": "MI",
            "postal_code": "484618842",
            "telephone_number": "810-610-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "4101006817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LLMFT",
            "identifier": "4101006817",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in North Branch, MI
• Providers in North Branch, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.