Active NPI
Johnetta Samuels, MS, ALC
- Professional Counselor
- Mobile, AL
National Provider Identifier
1710477328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C2955A
- Practice address
- 7730 Creekwood Dr
Mobile, AL 36695-4064 - Phone
- (251) 423-9196
- NPI assigned
- May 18, 2018
- Last updated
- May 18, 2018
- 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 | C2955A | AL | Primary |
Addresses
Primary practice location
7730 Creekwood Dr
Mobile, AL 36695-4064
Mailing address
7730 Creekwood Dr
Mobile, AL 36695-4064
Phone (251) 423-9196
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C2955A | AL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Home Care Services, LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Home Health Agency
- Mobile, AL
- NPI 1003275942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526601600000",
"number": "1710477328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7730 CREEKWOOD DR",
"city": "MOBILE",
"state": "AL",
"postal_code": "366954064",
"telephone_number": "251-423-9196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7730 CREEKWOOD DR",
"city": "MOBILE",
"state": "AL",
"postal_code": "366954064",
"telephone_number": "251-423-9196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELS",
"first_name": "JOHNETTA",
"name_prefix": "Ms.",
"credential": "MS, ALC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-18",
"last_updated": "2018-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AL",
"license": "C2955A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
- Joseph Eugene Salvati III
- Mariarita Salvitti Fermin, MD
- Sam's Club Optical (Sam's Club Optical 30-8102)
- Sams East Inc (Sams Pharmacy 10-8102)
- Derek Samuels, MD
- Omar Alejandro Sanchez Villanueva, M.D.
- Amanda Lane Sanchez, DPT
- Jaime Javier Sanchez, PSY.D.
- Jose Alfredo Sanchez, MD
- Gregory Dean Sand, D.M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.