Samantha Denboer, M.S., PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9315 Issued in FL

Practice address

1555 Matthew Dr
Fort Myers, FL 33907-1734

Phone

(239) 533-9860

NPI assigned

Jul 6, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Samantha Koeppel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Gulfshore Behavioral Health

  • Psychologist
  • Fort Myers, FL
  • NPI 1144877424

  Clinical

  NPD Authorized official
• Marbela Medical Wellness Inc

  • General Practice Physician
  • Fort Myers, FL
  • NPI 1851766943
  NPD (past)

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699747200000",
    "number": "1841673100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 MATTHEW DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071734",
            "telephone_number": "239-533-9860",
            "fax_number": "239-533-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 MATTHEW DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071734",
            "telephone_number": "239-533-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENBOER",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "M.S., PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-06",
        "last_updated": "2023-11-12",
        "certification_date": "2023-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY9315",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "KOEPPEL",
            "prefix": "DR.",
            "credential": "M.S., PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dylan Andrew Demars, PMHNP-BC
• Mary Ellen T Demartini, ARNP
• John Aloysius Dempsey III, APRN
• Dena Paniccia LLC
• Rhode Dena
• Megan Rambo Denison, PHYSICIAN ASSISTANT
• Emily E Denk, CRNA
• Peter Michael Denk, M.D.
• Felicia L Dennard
• Amanda Lang Dennis, ARNP

• Clinical Psychologist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2023; 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.