Active NPI
Shari Samuel I, DOCTORATE
- Mental Health Counselor
- Modesto, CA
National Provider Identifier
1750646063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPCC5584
- Practice address
- 2908 Ashbrook CT
Modesto, CA 95355-8623 - Phone
- (916) 890-6255
- NPI assigned
- Jul 12, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH12500 | FL | |
| Mental Health Counselor | 101YM0800X | LPCC5584 | CA | Primary |
Addresses
Primary practice location
2908 Ashbrook CT
Modesto, CA 95355-8623
Mailing address
2908 Ashbrook CT
Modesto, CA 95355-8623
Phone (916) 890-6255
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC5584 | CA | MD | Mental Health Counselor |
| MH12500 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770940800000",
"number": "1750646063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2908 ASHBROOK CT",
"city": "MODESTO",
"state": "CA",
"postal_code": "953558623",
"telephone_number": "916-890-6255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2908 ASHBROOK CT",
"city": "MODESTO",
"state": "CA",
"postal_code": "953558623",
"telephone_number": "916-890-6255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "SHARI",
"name_suffix": "I",
"credential": "DOCTORATE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-12",
"last_updated": "2026-02-13",
"certification_date": "2026-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH12500",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "LPCC5584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.