Samantha Jo Simon, PHD, LCMHC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

13168 Issued in NC

Practice address

2709 Blue Ridge Rd Ste 190
Raleigh, NC 27607-6462

Phone

(984) 355-0422

NPI assigned

May 5, 2020

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

Other names 1

• Samantha Simon Lohorn Professional name

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Devang Family Services

  • Mental Health Counselor
  • Raleigh, NC
  • NPI 1992410716
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1588285167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 BLUE RIDGE RD STE 190",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076462",
            "telephone_number": "984-355-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 BLUE RIDGE RD STE 190",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076462",
            "telephone_number": "984-355-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "PHD, LCMHC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-05",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "13168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "LOHORN",
            "middle_name": "SIMON",
            "credential": "LCMHC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• William Simmons
• Elizabeth W Simms, LCSW
• Simon Pogue Melcher, DDS, PLLC
• Brittany Simon
• Cicely Simon
• Shoshana Susan Simon, MSN, RN, CS
• Spencer E Simon, PA
• Dory Rae Simonsen, LCSW
• Nikolai Simonsen, DC
• Mary Marshall Simonson, LPC

• Mental Health Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.