Samantha Jean Wedderburn, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

014353 Issued in NY

Practice address

233 Blue Haw Dr
Moncks Corner, SC 29461-5285

Phone

(516) 366-1002

NPI assigned

Jan 26, 2024

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

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

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1649032509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 BLUE HAW DR",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294615285",
            "telephone_number": "516-242-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 BLUE HAW DR",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294615285",
            "telephone_number": "516-366-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDDERBURN",
        "first_name": "SAMANTHA",
        "middle_name": "JEAN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-26",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "10014",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "014353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John E Washington
• Amy Lynn Watson, LPC
• Taivonna Way
• Victoria Way
• Rebecca J Weaver
• Were All Wonders
• Kristi A West, APRN
• Jayden Olivia Weston, COTA
• Tarsha N Wheaton
• Whiplash Pain Center of Moncks Corner, LLC

• Mental Health Counselor in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.