Individual provider Active NPI

Samantha Burleson

  • Counseling Psychologist
  • Kapolei, HI
National Provider Identifier
1922828417
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Practice address
92-1133 Panana St Apt 1003
Kapolei, HI 96707-3737
Phone
(920) 342-3197
NPI assigned
Oct 10, 2024
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X HI Primary
Behavior Technician 106S00000X RBT-24-359224 HI

Addresses

Primary practice location

92-1133 Panana St Apt 1003
Kapolei, HI 96707-3737

Mailing address

92-1133 Panana St Apt 1003
Kapolei, HI 96707-3737
Phone (920) 342-3197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RBT-24-359224HIMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1922828417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92-1133 PANANA ST APT 1003",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967073737",
            "telephone_number": "920-342-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92-1133 PANANA ST APT 1003",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967073737",
            "telephone_number": "920-342-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURLESON",
        "first_name": "SAMANTHA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-10",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "HI",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "HI",
            "license": "RBT-24-359224",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.