Individual provider Active NPI

Samantha Bookman, MFT

  • Mental Health Counselor
  • Agoura Hills, CA
National Provider Identifier
1710312244
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
42917 Issued in CA
Practice address
5567 Meadow Vista Way
Agoura Hills, CA 91301-1506
Phone
(818) 661-8127
NPI assigned
Sep 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 42917 CA Primary

Addresses

Primary practice location

5567 Meadow Vista Way
Agoura Hills, CA 91301-1506

Mailing address

5567 Meadow Vista Way
Agoura Hills, CA 91301-1506
Phone (818) 661-8127

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

State licenses

LicenseStateTypeSpecialty
42917CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1710312244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5567 MEADOW VISTA WAY",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913011506",
            "telephone_number": "818-661-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5567 MEADOW VISTA WAY",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913011506",
            "telephone_number": "818-661-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKMAN",
        "first_name": "SAMANTHA",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "42917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agoura Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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.