Rebecca Jean Pryor Samuel, LCMHCA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A18314 Issued in NC

Practice address

328 Whippoorwill LN
Mt Holly, NC 28120-9765

Phone

(704) 827-3788

NPI assigned

Dec 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Shining Hope Farms

  • Occupational Therapist
  • Mount Holly, NC
  • NPI 1144369224
  NPD (past)

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1790497477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072133",
            "telephone_number": "703-477-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 WHIPPOORWILL LN",
            "city": "MT HOLLY",
            "state": "NC",
            "postal_code": "281209765",
            "telephone_number": "704-827-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "REBECCA",
        "middle_name": "JEAN PRYOR",
        "credential": "LCMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A18314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverbend Family Physicians
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• Rachael Danielle Ryan, PHARMD
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• Hannah Sawyer, LCMHCA
• Ashley Pearl Seal, O.T.R.L
• James Evans Shearer II, D.D.S.
• Alexandria Shepherd, OTR/L

• Professional Counselor in Mt Holly, NC
• Providers in Mt Holly, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.