Elissa Samuels, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC3747 Issued in MD

Practice address

9701 Keysville Rd
US Route 15 and Keysville Road
Emmitsburg, MD 21727-8619

Phone

(301) 447-2361

Fax

(301) 447-3715

NPI assigned

Apr 10, 2014

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

Medicare fee-for-service enrollment

Enrolled in MD

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Life Change Therapy Now LLCGroup PAC ID 4284010117, 8 clinicians

Practice addresses (Care Compare)

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.

• Life Change Therapy Now LLC

  • Clinical Social Worker
  • Frederick, MD
  • NPI 1780121392
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1699194282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 136",
            "address_2": "9701 KEYSVILLE ROAD, US ROUTE 15 AND KEYSVILLE ROAD",
            "city": "EMMITSBURG",
            "state": "MD",
            "postal_code": "217270136",
            "telephone_number": "301-447-2361",
            "fax_number": "301-447-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 KEYSVILLE RD",
            "address_2": "US ROUTE 15 AND KEYSVILLE ROAD",
            "city": "EMMITSBURG",
            "state": "MD",
            "postal_code": "217278619",
            "telephone_number": "301-447-2361",
            "fax_number": "301-447-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "ELISSA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC3747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Potomac Healthcare Foundation, LTD
• Recovery Health Services, LLC
• John Allen Reilly, M.D., M.S.
• Griffin Rooker, BCBA, LBA
• Deysy Salgado
• John Sestina
• Ryan Clark Sharpless, PHARMD
• Vaughn Sheroda
• Megan Kathleen Sim, NP
• Ann Sherman Springer, M.S. CCC, S/LP

• Professional Counselor in Emmitsburg, MD
• Providers in Emmitsburg, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.