Kenneth Earl Samuda

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

13180 Gaston Ave
Laurinburg, NC 28352-5952

Phone

(910) 318-2176

NPI assigned

Dec 7, 2022

Last updated

Dec 7, 2022By the provider in NPPES

Sex

Male

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

Practice roles

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.

• Emanuel's Sons and Daughters of Promise

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Laurinburg, NC
  • NPI 1366144677
  NPD Authorized official
• Kenneth Samuda Counseling Services

  • Substance Abuse Rehabilitation Facility
  • Laurinburg, NC
  • NPI 1831900521
  NPD Authorized official
• Emanuel's Sons and Daughters of Promise

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Laurinburg, NC
  • NPI 1033813621
  NPD

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1740991041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13180 GASTON AVE",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525952",
            "telephone_number": "910-318-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13180 GASTON AVE",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525952",
            "telephone_number": "910-318-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUDA",
        "first_name": "KENNETH",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Ann Russell, CRNA
• Rebecca Amber Crowe Russell, M.S. , CCC-SLP
• Ryan, James, Wiles, Patel & Olsen LLP (Village Family Dental)
• Montell D Salary, M.D.
• Leslie John Salloum, MD
• Teresa Samuel, LCSW
• Margaret L Sanders, PH.D
• Sandhills Behavioral Center Inc
• Sandhills Cardiology, PC
• Bettye Jean Sanford-Joseph, MS, LPCA

• Addiction (Substance Use Disorder) Counselor in Laurinburg, NC
• Providers in Laurinburg, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.