Samantha Lynn Eldred, MA LLP CAADC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301015585 Issued in MI

Practice address

117 W 3Rd St
Royal Oak, MI 48067-3831

Phone

(248) 965-6605

NPI assigned

Sep 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1730438581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W 3RD ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673831",
            "telephone_number": "248-965-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W 3RD ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673831",
            "telephone_number": "248-965-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRED",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MA LLP CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-06",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-03096",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faheem Ejaz, D.O
• Ali Issam El-Habhab, D.C.
• Carol El-Sayah, PA-C
• Nidal El-Wiher, M.D.
• Haneen Elder, PA
• Anas Elghonimy, RPH
• Dina Elhabashy
• Chady Ahmed Elhage, D.D.S., M.S.
• Christopher Elia, D.O.
• Bianca Elias, MD

• Clinical Psychologist in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.