Samantha Thomaston

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

003524 Issued in GA

Practice address

111 Holleys Grove Dr
Lagrange, GA 30240-7761

Phone

(706) 812-8764

NPI assigned

May 18, 2020

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

Medicare enrollment (NPD)

Not enrolled

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.

• SLT Counseling Services LLC

  • Professional Counselor
  • Lagrange, GA
  • NPI 1043884158
  NPD Authorized official

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1871116459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HOLLEYS GROVE DR",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302407761",
            "telephone_number": "706-812-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HOLLEYS GROVE DR",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302407761",
            "telephone_number": "706-812-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMASTON",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "003524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Veal Group, LLC
• Catlyn Nicole Thigpen, DO
• Venu Karthik Thirukonda, M.D
• Jennifer Thomas, APRN, PMHNP
• Jerry Lamar Thomas
• Blair Alexandria Thompson
• Charles Evans Thompson Jr., FNP-C
• Gina Renee Thompson
• Christina Noles Thornton
• Megan Thrasher, LPC

• Professional Counselor in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.