Samuel M Sabaka, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

5536 Issued in MN

Practice address

230 Marietta Hwy
Canton, GA 30114-2327

Phone

(770) 789-3797

NPI assigned

Feb 21, 2012

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

Credentials

Doctor of Philosophy

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.

• Goshen Valley Foundation Inc

  • Community/Behavioral Health Agency
  • Canton, GA
  • NPI 1710238787
  NPD (past)

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1821361882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LAUREL TRCE SE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301206506",
            "telephone_number": "770-324-8647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MARIETTA HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142327",
            "telephone_number": "770-789-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABAKA",
        "first_name": "SAMUEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-21",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "003491",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "5536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea W. Russell, D.M.D.
• Carl M. Russell, DMD, PHD
• William Dirk Russell, D.M.D.
• James Michael Rutherford, CRNA
• Terri Rybak, CST/CSFA
• Najam Sabreen, MD
• Jennifer-Linda S Saccoccia, MS, NCC, LAPC
• Giselle Sadeghi, DMD
• Sage Dental Group of Georgia, LLC
• Behnaz Samimi Darzikolaei

• Psychologist in Canton, GA
• Providers in Canton, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.

Verify at the official NPI Registry.