Samantha L Graham-Douglas, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

2007035322 Issued in MO

Practice address

681 S Lincoln Dr Ste 3
Troy, MO 63379-2835

Phone

(636) 528-4333

Fax

(636) 338-4203

NPI assigned

Feb 17, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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 and National Provider Directory roles.

• Life Restoration Center

  • Professional Counselor
  • Troy, MO
  • NPI 1417209917
  NPD (past) Authorized official
• Catholic Family Services Inc.

  • Mental Health Counselor
  • Union, MO
  • NPI 1154480176
  NPD (past)
• Preferred Family Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hannibal, MO
  • NPI 1306721709
  NPD (past)

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

{
    "created_epoch": "1203206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1538337159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 WILD TURKEY LN",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633794339",
            "telephone_number": "636-358-6021",
            "fax_number": "636-338-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 S LINCOLN DR STE 3",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792835",
            "telephone_number": "636-528-4333",
            "fax_number": "636-338-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM-DOUGLAS",
        "first_name": "SAMANTHA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-17",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2007035322",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2007035322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica M Goltzman
• Katie Lynn Goodman, LMSW
• Kelly Gowen, RN
• Jessica Graf, P.T.
• Aaron Grah
• Marietta Graham-Lopez, RN, CS FNP
• Crystal Leigh Graver
• Greatsmiles, Inc.
• Kirstynn Greer, PLPC
• Lori Alice Griffith, P.T.

• Counselor in Troy, MO
• Providers in Troy, MO by specialty
• Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.