Individual provider Active NPI

Samantha Marlowe Maederer, LMHC

  • Mental Health Counselor
  • St Petersburg, FL
National Provider Identifier
1790213585
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH13959 Issued in FL
Practice address
2020 30TH Ave N
St Petersburg, FL 33713-4163
Phone
(727) 434-9887
NPI assigned
May 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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 MH13959 FL Primary

Addresses

Primary practice location

2020 30TH Ave N
St Petersburg, FL 33713-4163

Mailing address

PO Box 10970
St Petersburg, FL 33733-0970
Phone (727) 327-7656

Other practice location 1

1001 16th St S
St Petersburg, FL 33705-2231
Phone (727) 327-7656

Other practice location 2

675 30th Ave N Ste 101
St Petersburg, FL 33704-2158
Phone (727) 434-9887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231215001136 FL Practitioner - Mental Health Counselor 9739538786 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maederer Counseling LLC Mental Health CurrentSince Apr 13, 2025 Accepting new patients
Suncoast Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

4024 Central Ave
St Petersburg, FL 33711

1001 16th St S
St Petersburg, FL 33705
Phone (727) 242-1775

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1790213585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10970",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337330970",
            "telephone_number": "727-327-7656",
            "fax_number": "727-322-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 30TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337134163",
            "telephone_number": "727-434-9887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 16th St S",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337052231",
            "country_code": "US",
            "telephone_number": "727-327-7656",
            "fax_number": "727-322-2110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "675 30th Ave N Ste 101",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337042158",
            "country_code": "US",
            "telephone_number": "727-434-9887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAEDERER",
        "first_name": "SAMANTHA",
        "middle_name": "MARLOWE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.