Samantha Nicole Speed

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

APC006696 Issued in GA

Practice address

1640 Powers Ferry Rd SE Ste 250
Marietta, GA 30067-5491

Phone

(704) 873-1011

Fax

(704) 832-2253

NPI assigned

Feb 3, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Samantha Nicole Carney Former name

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": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1538527700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11307 JEFFERSON CIR N",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303412699",
            "telephone_number": "980-622-9735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE STE 250",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "704-873-1011",
            "fax_number": "704-832-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEED",
        "first_name": "SAMANTHA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-03",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A12038",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A12038",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC006696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "CARNEY",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Spectrum Health Services
• Speech Adventures, LLC
• Speech and Feeding Solutions LLC
• Speech Sounds, LLC
• Ingrid Speed
• Ethan Jesse Speir, MD
• Spelios and Associates Delk Road PC
• Spelios and Associates- Summitt PC
• Kimberly Spellman, PHD, LPC, NCC
• Kareema Spells

• Mental Health Counselor in Marietta, GA
• Providers in Marietta, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; 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.