Shashondalyn Shanay Samuels, CM

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC016534 Issued in GA

Practice address

1944 Brannan Rd
McDonough, GA 30253-4310

Phone

(678) 289-6981

NPI assigned

Jun 17, 2019

Last updated

Mar 16, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eagle's Landing Christian Counseling Center, Inc.

  • Professional Counselor
  • McDonough, GA
  • NPI 1093955205
  NPD (past)
• Suncoast Center Inc

  • Case Management Agency
  • St Petersburg, FL
  • NPI 1457021321
  NPD (past)
• Suncoast Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Petersburg, FL
  • NPI 1659371763
  NPD (past)

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1528628104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 HONEY CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302528503",
            "telephone_number": "470-923-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1944 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-289-6981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "SHASHONDALYN",
        "middle_name": "SHANAY",
        "name_prefix": "Ms.",
        "credential": "CM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC016534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam Select
• Sam's Club Optical (Sam's Club Optical 30-4804)
• Marquis Sampson
• Sams East Inc (Sams Pharmacy 10-4804)
• Samantha O Samuels, BS,CPS
• Charmin Sanders, P.T.
• Sekhar C Sankaran, MD
• Lala Sanyang
• Sonia Sapp, LAPC
• Tanisha Sapp, LPC

• Professional Counselor in McDonough, GA
• Providers in McDonough, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.