Nicole Sampson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH23634 Issued in FL

Practice address

19105 N US Highway 41 Ste 300
Lutz, FL 33549-4206

Phone

(813) 421-4405

NPI assigned

Feb 21, 2023

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.

• Sundance Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Odessa, FL
  • NPI 1003751561
  NPD Authorized official

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1972201770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19105 N US HIGHWAY 41 STE 300",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335494206",
            "telephone_number": "813-421-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19105 N US HIGHWAY 41 STE 300",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335494206",
            "telephone_number": "813-421-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH23634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leena Chacko Saline, D.O.
• Christina Salinsky, RPH
• Carolyn Salmon
• Binsey Dawn Sam, PA-C
• Samantha S. Lindsay M.D. P.a.
• Sandhill Pediatrics, P.a.
• Sandhill Speech and Language Services, LLC
• Daphnne Sanjur, RBT
• Ricardo Sanpedro, D.D.S.
• Rose Marie Santos, OTR/L

• Mental Health Counselor in Lutz, FL
• Providers in Lutz, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.