Samantha Shump, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401014857 Issued in MI

Practice address

4370 Chicago Dr SW # 515
Grandville, MI 49418-1694

Phone

(616) 287-2283

NPI assigned

Mar 6, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

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.

• Suppression Expression Counseling, LLC

  • Mental Health Counselor
  • Grandville, MI
  • NPI 1811641855
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649805003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 CHICAGO DR SW # 515",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181694",
            "telephone_number": "616-287-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 CHICAGO DR SW # 515",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181694",
            "telephone_number": "616-287-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMP",
        "first_name": "SAMANTHA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-06",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "6401014857",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marrissa L Sheehy, LPN
• Sheeran Chiropractic, P.L.L.C.
• Patrick John Sheeran, D.C.
• Anton T Sheridan
• Mary Ann Shuman, LPC LICENSED PROFESS
• Sandy L Sian
• Richard Sieting
• Andrea Leigh Simon
• Rachel Sheridan Sinacola, D.D.S., M.S.
• Anthony Sleep

• Professional Counselor in Grandville, MI
• Providers in Grandville, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.