Samantha Hernandez

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

18885 Issued in AZ

Practice address

2622 S 102ND LN
Tolleson, AZ 85353-5678

Phone

(480) 442-7635

NPI assigned

Jun 28, 2020

Last updated

Dec 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective May 6, 2024 through May 6, 2028

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cognitive Transformationz LLC

  • Mental Health Counselor
  • Tolleson, AZ
  • NPI 1992318562
  NPD Authorized official

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

{
    "created_epoch": "1593302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1811514680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 304",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853530304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 S 102ND LN",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853535678",
            "telephone_number": "480-442-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-28",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "18885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harmony Provider Care LLC
• Harper Health PLLC
• Megi Heltemes, PHARMD
• Jenipher Hensley, RN
• Katherine Nicole Hermann
• Steven Hill
• Eugene Hnatiw
• Holyheight Care LLC
• Honorhealth-Fastmed Ambulatory Holdings LLC (HonorHealth FastMed Urgent Care)
• Desiree Deshora Horner

• Mental Health Counselor in Tolleson, AZ
• Providers in Tolleson, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.