Samantha R Wunderlich, CTRS, CBIS, CZT

Primary specialty

Recreation TherapistTaxonomy code 225800000X

License

60142 Issued in MI

Practice address

293 Leroy St
Ferndale, MI 48220-1890

Phone

(248) 629-0002

Fax

(248) 808-6311

NPI assigned

Apr 30, 2012

Last updated

Feb 20, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1710245683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20274",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482200274",
            "telephone_number": "248-629-0002",
            "fax_number": "248-808-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 LEROY ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201890",
            "telephone_number": "248-629-0002",
            "fax_number": "248-808-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLICH",
        "first_name": "SAMANTHA",
        "middle_name": "R",
        "credential": "CTRS, CBIS, CZT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "MI",
            "license": "60142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnny Jo Wright, LLCSW
• Stacy M Wright, LLP, LPC
• Crystal Wrubel, DC
• Shawn Jonathan Wrubel, D.C.
• Wuerth Care Psychodynamic Therapy, LLC
• Bethany Xiong, PA-C
• Pheng Yang, PHARMD
• Jessica York, LMT
• Ann Marie Young
• Lisa Youngs, LLMSW

• Recreation Therapist in Ferndale, MI
• Providers in Ferndale, MI by specialty
• Recreation Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.