Active NPI
Shannon Samuel, LPC, LPCC
- Professional Counselor
- Pearland, TX
National Provider Identifier
1679294532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 11200 Broadway St Ste 2743
Pearland, TX 77584-9787 - Phone
- (832) 910-7476
- NPI assigned
- Sep 8, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | TX | Primary |
Addresses
Primary practice location
11200 Broadway St Ste 2743
Pearland, TX 77584-9787
Mailing address
3422 Business Center Dr Ste 106
Pearland, TX 77584-4159
Phone (832) 910-7476
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shine Medical Providers PC | Multi-Specialty | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768003200000",
"number": "1679294532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3422 BUSINESS CENTER DR STE 106",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775844159",
"telephone_number": "832-910-7476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11200 BROADWAY ST STE 2743",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775849787",
"telephone_number": "832-910-7476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "SHANNON",
"credential": "LPC, LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-08",
"last_updated": "2026-01-10",
"certification_date": "2026-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.