Samantha Jo Devine, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2017026551 Issued in MO

Practice address

5 Premier Dr Ste 200
Fenton, MO 63026-2943

Phone

(314) 544-3800

NPI assigned

Sep 5, 2019

Last updated

Jul 8, 2024By the provider in NPPES

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 Jo Forehand Former name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: No
• 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

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Louis Counseling Inc

  • Voluntary or Charitable Agency
  • Fenton, MO
  • NPI 1053397133
  Medicare reassignment NPD
• Catholic Family Services Inc.

  dba Family Wellness Program

  • Mental Health Counselor
  • Union, MO
  • NPI 1154480176
  NPD

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1669021457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PREMIER DR STE 200",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262943",
            "telephone_number": "314-544-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PREMIER DR STE 200",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262943",
            "telephone_number": "314-544-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MO",
            "license": "2017026551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "FOREHAND",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly L Degeare, MSW, LCSW
• Delmar Gardens of Meramec Valley Operating, LLC (Delmar Gardens of Meramec Valley)
• Delta Health
• Anne Demerit
• Stacie D Detmer, FNP
• Dierbergs Markets, Incorporated (Dierbergs Fenton Crossing Pharmacy)
• Digital X Mobile, Inc.
• Michelle Dillon
• Lucia Dinges, RN
• Michael B Dixon, M.D.

• Marriage & Family Therapist in Fenton, MO
• Providers in Fenton, MO by specialty
• Marriage & Family Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.