Samantha Lauren Penedos, LPC, ATR

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC013187 Issued in PA

Practice address

177 Timber TRL
Greentown, PA 18426-2552

Phone

(610) 823-3185

NPI assigned

Apr 20, 2021

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 names 1

• Samantha Lauren Blanchard Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thaxton Holistic Wellness CenterGroup PAC ID 2769818418, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Thaxton Holistic Wellness Center

  • Professional Counselor
  • Scranton, PA
  • NPI 1609243898
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1659952604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 TIMBER TRL",
            "city": "GREENTOWN",
            "state": "PA",
            "postal_code": "184262552",
            "telephone_number": "610-823-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 TIMBER TRL",
            "city": "GREENTOWN",
            "state": "PA",
            "postal_code": "184262552",
            "telephone_number": "610-823-3185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENEDOS",
        "first_name": "SAMANTHA",
        "middle_name": "LAUREN",
        "name_prefix": "Miss",
        "credential": "LPC, ATR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC013187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "BLANCHARD",
            "middle_name": "LAUREN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Aaron John Niznick, DPT, ATC
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• Ross Reichman
• Katherine Victoria Reinoso-Orta
• Jenni Lee Ward, LCSW

• Professional Counselor in Greentown, PA
• Providers in Greentown, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.