Active NPI
John Samaha
- Professional Counselor
- Monroe, WI
National Provider Identifier
1699314997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7652-125
- Practice address
- 1518 11TH St Ste 1-4
Monroe, WI 53566-1701 - Phone
- (608) 325-1070
- NPI assigned
- Jan 3, 2020
- Sex
- Male
- Sole proprietor
- No
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 | 7652-125 | WI | Primary |
Addresses
Primary practice location
1518 11TH St Ste 1-4
Monroe, WI 53566-1701
Mailing address
1518 11TH St Ste 1-4
Monroe, WI 53566-1701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7652-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avenues Counseling, LLC | Current | Accepting new patients |
Locations
1518 11th St
Ste 1-4
Monroe, WI 53566
Phone (608) 325-1070
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": "1578009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578009600000",
"number": "1699314997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1518 11TH ST STE 1-4",
"city": "MONROE",
"state": "WI",
"postal_code": "535661701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1518 11TH ST STE 1-4",
"city": "MONROE",
"state": "WI",
"postal_code": "535661701",
"telephone_number": "608-325-1070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMAHA",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-03",
"last_updated": "2020-01-03",
"certification_date": "2020-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "7652-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.